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Regional Streeters

36th Annual Rod & Custom Car Show

JUNE 2nd & 3rd  2012

Lake County Fairgrounds, Crown Point, IN

PRE-ENTRY FORM

Name ________________________________________________________________

Address ______________________________________________________________

City __________________________________________________________________

State _______Zip Code________ E-Mail Address________________  Distance Traveled__________

Vehicle Entry ______    # of Swap Space ________  # of Craft Space  _______

Make of Car  _______________   Model _____________      Color ________________

Year _________ Club Affiliation_____________________ Signature___________________________

                               Pre-Entry                  Day of Show

Vehicle Entry                     $20  (T-Shirt)                       $25

Swap Space                         $20                                      $25

Crafter Space                     $20                                       $25

Pre Entries must be postmarked by May 13, 2012

MAIL ENTRY TO:

REGIONAL STREETERS

P.O. BOX 656

CROWN POINT, IN 46308

ATTN:  Bob Luther

Make check payable to:

Regional Streeters

Entry fee includes 2 Days for 2 adults & 2 kids

Pre-Register by 5/13/2012 - Free T-Shirt to Pre-Registers (Car Show only) (Circle One)    S   M   L   XL

Add $2 -  2X   3X   4X

I agree that Regional Streeters and or Lake Co. Fairgrounds is not responsible for loss or injury to myself or property. Any and all liability for such loss, damage or injury shall be assumed by myself. NO ALCOHOL, BICYCLES, OR PETS PLEASE.