Jeffs 2015 entry form one side
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ENTRY FEE $30.00 ENTRY FEE INCLUDES A FREE T-SHIRT ONLY ENTRIES POSTMARKED or POSTED ONLINE BEFORE DECEMBER 31 st 2014 RECEIVE A FREE T-SHIRT Please make all checks payable and send to: Pickups Limited of Orange County P.O. Box 4631 Anaheim, Ca 92803 Register online at: www.jeffsfunrun.com ALL CONFIRMATIONS WILL BE SENT VIA E-MAIL Register on at www.jeffsfunrun.com via Pay Pal or Credit Card ENTRY FORM: Name:____________________________________________ Address: __________________________________________ City: ___________________ State: _______ ZIP: _________ Area Code: ________ Phone: _________________________ E-Mail: ____________________________________________ CONFIRMATIONS WILL BE SENT VIA E-MAIL VEHICLE INFORMATION Make: __________ Model: ______________ Year: ________ Club Afiliation: _____________________________________ NO LOUD MUSIC, ALCOHOL, RACING OF MOTORS, BURNOUTS, BBQ'S OR OPEN FIRES IN THE SHOW AREA I HAVE READ AND UNDERSTAND THIS FORM AND WILL ABIDE BY ALL RULES AND STATED RESTRICTIONS SIGNATURE: ____________________________________________________ DATE: _______________________________ PUBLICATION & LIABILITY RELEASE: I hereby consent to the use and publication of any photos in which I or my vehicle may appear, either intentionally or unintentionally in whole or in part. I understand that all photographs are the sole property of Pickups Limited of Orange County and their assignees. Entrants and participants by execution of this entry form, release and hold harmless Pickups Limited of Orange County, Ken Grody Ford, any Vendors, DJ's, Bands and Food Vendors, their officers, directors, employees, agents representatives, and anyone connected with the presentation of the Jeff’s Fun Run from any known and unknown damages, injuries, losses, judgments, or claims from any causes what-so-ever that may be suffered by any entrants or participant to his person and property. I would love to attend but can’t make it. For an additional $8, please mail my shirt at the address on this form. A LIMITED NUMBER OF EVENT SHIRTS WILL BE AVAILABLE THE DAY OF THE RUN For more information contact: [email protected] or call (657) 464-3115 Beach Bl Orangethorpe Commonwealth 5 Freeway 91 Freeway Event Starting Time - 8:30am Ken Grody Ford %HDFK %OYG %XHQD 3DUN &$ )UHHZD\ H[LW DW %HDFK %OYG 1RUWK WR &RPPRQZHDOWK ZZZNHQJURG\IRUGFRP OPEN TO ALL MAKES, MODELS, AND YEARS OF VEHICLES Saturday January 17 th , 2015 The Poker Run Begins at 8:30am - Rain or Shine - OVER 200 VEHICLES • www.jeffsfunrun.com ORDER FORM: Standard Entry Fee - INCLUDES FREE EVENT SHIRT BEFORE DECEMBER 31 st 2014 $30 = $________ select your FREE shirt when you enter before December 31 st S___ M ___ L ___ XL___ XXL___ XXXL___ Order Additional Short Sleeve Event T-Shirts S___ M ___ L ___ XL___ XXL___ XXXL___ ______ @ $20 = $________ $8 POSTAGE = $________ TOTAL $________
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Transcript of Jeffs 2015 entry form one side
JFR #7
ENTRY FEE $30.00 ENTRY FEE INCLUDES A FREE T-SHIRT
ONLY ENTRIES POSTMARKED or POSTED ONLINE BEFORE DECEMBER 31st 2014 RECEIVE A FREE T-SHIRT
Please make all checks payable and send to:Pickups Limited of Orange County
P.O. Box 4631Anaheim, Ca 92803
Register online at: www.jeffsfunrun.com ALL CONFIRMATIONS WILL BE SENT VIA E-MAIL
Register on at www.jeffsfunrun.com via Pay Pal or Credit Card
ENTRY FORM:
Name:____________________________________________
Address: __________________________________________
City: ___________________ State: _______ ZIP: _________
Area Code: ________ Phone: _________________________
E-Mail: ____________________________________________CONFIRMATIONS WILL BE SENT VIA E-MAIL
VEHICLE INFORMATIONMake: __________ Model: ______________ Year: ________
Club Afiliation: _____________________________________
NO LOUD MUSIC, ALCOHOL, RACING OF MOTORS, BURNOUTS, BBQ'S OR OPEN FIRES IN THE SHOW AREAI HAVE READ AND UNDERSTAND THIS FORM AND WILL ABIDE BY ALL RULES AND STATED RESTRICTIONS
SIGNATURE: ____________________________________________________ DATE: _______________________________
PUBLICATION & LIABILITY RELEASE: I hereby consent to the use and publication of any photos in which I or my vehicle may appear, either intentionally or unintentionally in whole or in part. I understand that all photographs are the sole property of Pickups Limited of Orange County and their assignees. Entrants and participants by execution of this entry form, release and hold harmless Pickups Limited of Orange County, Ken Grody Ford, any Vendors, DJ's, Bands and Food Vendors, their officers, directors, employees, agents representatives, and anyone connected with the presentation of the Jeff’s Fun Run from any known and unknown damages, injuries, losses, judgments, or claims from any causes what-so-ever that may be suffered by any entrants or participant to his person and property.
I would love to attend but can’t make it. For an additional $8, please mail my shirt at the address on this form.
A LIMITED NUMBER OF EVENT SHIRTS WILL BE AVAILABLE THE DAY OF THE RUN
For more information contact: [email protected] or call (657) 464-3115
Beac
h Bl
Orangethorpe
Commonwealth
5 Freeway
91 Freeway
Event Starting Time - 8:30amKen Grody Ford
OPEN TO ALL MAKES, MODELS, AND YEARS OF VEHICLESSaturday January 17th, 2015
The Poker Run Begins at 8:30am - Rain or Shine - OVER 200 VEHICLES • www.jeffsfunrun.com
ORDER FORM:Standard Entry Fee - INCLUDES FREE EVENT SHIRT BEFORE DECEMBER 31st 2014 $30 = $________select your FREE shirt when you enter before December 31st
S___ M ___ L ___ XL___ XXL___ XXXL___
Order Additional Short Sleeve Event T-Shirts S___ M ___ L ___ XL___ XXL___ XXXL___ ______ @ $20 = $________
$8 POSTAGE = $________
TOTAL $________
