WALTER P. CHRYSLER CLUB                                                      10,000 LAKES REGION                       19th ANNUAL CAR SHOW                         

                    Sunday, August 13th, 2017      10:00 am to 2:00 pm       RAIN or SHINE  

All Chrysler (MOPAR), AMC/Jeep, and other Chrysler-related vehicles WELCOME

***Entries MUST have Chrysler or other Chrysler-related power plants***

$10.00 registration fee per car

Proceeds go to -   Iacocca Family Foundation for Diabetes Research iacoccafoundation.org

Co-sponsored & Hosted by

                    

                                  Wagner's Family Drive-In     

   7000 West Broadway Ave.        Brooklyn Park, MN.              (763) 533-8262

  Awards for:  Pre-War-1939, 1940-1950, 1951-1960, 1961-1970, 1971-1980, 1981-1999, 2001-present   Best-in-Show                                                                                                 

Dash Plaques           Door Prizes           50/50 Drawing           Voting done by entrants

****************************************************CLIP HERE FOR PRE-REGISTRATION ****************************************************************

       Include $10.00 check + this form and mail to:  WPC Club 10,000 Lakes Region  c/o Bob Smith, Treasurer                                          5045 16th Ave. S.  Minneapolis, MN  55417                    For information, contact Garry or Mickey at 651-646-5753.  

NAME________________________________________________________ TELEPHONE #______________________________________

ADDRESS_____________________________________________CITY_____________________________STATE______ZIP____________

MAKE____________________________________________ MODEL___________________________________ YEAR________________

In consideration for the right to participate, all entrants discharge (by signing this form) the 10,000 Lakes Region of the Walter P. Chrysler Club LLC, Wagner's Family Drive-In, all other sponsors, employees, workers, volunteers and other agents and/or anyone else connected with this event, from any known or unknown damages, injuries, losses, judgments and/or claims from any cause whatsoever that may be incurred by any entrant to his or her property. Each entrant also expressly agrees to indemnify all of the foregoing entities, persons or bodies of and from all liability occasioned or resulting from the conduct of entrants, spectators or other participants. Event management reserves the right to restrict participants and spectators to acceptable behavior during the event. If, for any reason, an entrant's actions or vehicles are deemed unacceptable by management, the parties and/or vehicles involved will be asked to leave the premises. Objectionable behavior off the premises may be grounds for denial of entrance to the event.  

Signed ___________________________Date_____________