NCRS ST. LOUIS CHAPTER MEET & PICNIC

9:30 A.M.  Saturday, October 16, 2010

 

**Pre-registration Package Deadline: September 15, 2010.

 

All NCRS Members are requested to register by Mail or call if planning to attend.

 

Name:  Spouse / Companion:

Address:  City: State:    Zip:

Phone: (Home)  Work: Fax:

Current NCRS Membership #: E-mail:

CORVETTE REGISTRATION: (One Registration form per car)

Flight Judging Entry:

 @ $20

Sportsman: @ $5
Bowtie: Duntov:  Special Interest:  FREE

  Make Checks Payable to 'NCRS St. Louis Chapter'      Total: 

Car Information:  Year  Coupe Convertible

Engine CI/HP:  Complete VIN:  

JUDGING PARTICIPATION

I would like to Judge in class: 

 1st Choice:

2nd Choice:

Judging Level:

I would like to Judge : 

 Int:     Ext:    Mech:

    Class:

I would like to be an observer judge:   I would like to tabulate:   Tabulation level:

Hold Harmless Agreement:

I agree to insure my vehicle and property against loss, damage & liability and to provide proof of such insurance to NCRS. I agree to assume the risk of any and all damage or injury and to indemnify and hold harmless NCRS, its officers, directors, agents, employees, and chapters for any such acts of omissions which may result in the theft, damage or destruction of my property or injury to me or others occurring during or as a consequence of this meet, wherever located.

Signature _______________________Date: Insured with:   

Policy Number:  Expires

 

 

 

 

* The number of entries are limited. Call or email prior to mailing FlightŪ registration.

   After acceptance, registration receipt is required within 7 days.

 

Mail registrations to:

Mark Markel

5033 Royal Burgess

St. Charles Mo 63304

email: markels4@ sbcgobal.net or Phone:636-922-9196