August 21, 2011

12th Annual

REGISTRATION: ___________

Return this form before July 1st, 2011 along your total payment below to:

NWCCC 2011 Car Show
13188 SE Newport Way #M201
Bellevue, WA 98006

12th Annual - Celebrating 1955-1956-1957
Chevrolets cars, trucks & Corvettes

August 21, 2011 • XXX Drive-In • Issaquah, WA

Full Name
Address
City State Zip
Email
Phone
ModelColor
Year (Circle One): 55 - 56 - 57Car License #

q I’m interested in joining your club. Please send information.
q
E-mail me upcoming car events.
q
Please do not distribute my registration information to 2011 show sponsors.

 
PRE-REGISTRATION  (Pre-register and save $15.00! $20.00 Day of Show)$15.00
2008/2009/2010 SHOW COMMEMORATIVE DVD ($10.00/each)QTY: 
20101SHOW COMMEMORATIVE DVD ($15.00/each)QTY: 
  

TOTAL

 

Authorization: Northwest Classic Chevy Club and XXX Drive-In, as the promoters of the NW Classic Chevy Club 55-56-57 Show (the "Show"), may use pictures of my car taken during the course of the Show for promotion and/or publication purposes.

Release and Indemnification:  My participation in the Show constitutes an acknowledgment that I have inspected the area and other areas pertinent to the Show (“Premises”) and unconditionally accept the same.  I shall maintain full insurance on my property.  In consideration of NW Classic Chevy Club and XXX Drive-In (the "Promoters") allowing me to participate in the Show I, individually and on behalf of my marital community, representatives, heirs, next of kin and assigns, hereby assume full responsibility and waive, release and forever discharge the Promoters, Show sponsors, volunteers, and their officers, directors, employees, agents, representatives, and anyone else connected with the Show's management or presentation, Virginia Mason Clinic, The Learning Garden, and Staples (as owner/occupier of the property adjacent to the XXX Drive-In) (cumulatively the "Released Parties") from any and all claims, causes of action, damages, injuries, losses, and/or judgments, including, but not limited to, all bodily injuries and property damage, arising from or in any way connected with the Premises and my participation in or attendance at the Show, even if the same arises in whole or in part from the negligence of the Released Parties.  Further, I agree to indemnify, defend and hold harmless the Released Parties from any and all liability, claims, causes of action, demands and expenses, including lawyers' fees, arising from or in any way connected with my participation in or attendance at the Show.

This Agreement constitutes the parties' entire understanding and agreement, supersedes all prior oral and written understandings, agreements, negotiations, statements, representations, warranties, promises and commitments, and may not be changed except in writing signed by all parties.  This Agreement binds and inures to the benefit of the parties and their respective marital communities, personal representatives, heirs, successors, underwriters and assigns.  If a court of competent jurisdiction holds any provision of this Agreement to be invalid, unenforceable or against public policy, all other provisions will remain in effect and will be construed as if all provisions held to be invalid, unenforceable or against public policy are omitted.  In addition, an enforceable provision will be substituted, if possible, which meets the intent of the stricken provision.   

            ENTRANT REPRESENTS HE/SHE HAS READ AND FULLY UNDERSTANDS THE TERMS OF THIS  AGREEMENT, THAT ENTRANT HAS GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, THAT ENTRANT HAS SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY OTHER ORAL OR WRITTEN INDUCEMENT, ASSURANCE, GUARANTEE OR REPRESENTATION, AND INTENDS ENTRANT’S SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

 

 
Signature of Registrant (Required) Date
 

UNSIGNED ENTRIES WILL BE RETURNED