SHOW REGISTRATION

$25 PRE REGISTRATION MUST BE RECEIVED BY MARCH 10

NAME..........................................................................................................................................................................

ADDRESS....................................................................................................................................................................

CITY..................................................................STATE....................................................ZIP....................................

YEAR OF CAR.................................................MAKE.....................................................MODEL............................

BODY STYLE (CIRCLE ONE) ....COUPE....CONVERTIBLE....FASTBACK....SEDAN....PICK-UP....OTHER...

EXTERIOR COLOR...............................................CLUB AFFILIATION.................................................................

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SHOW CLASSES (CHECK ONE ONLY)

MUSTANGS

641/2-73: CONCOURS......................OCCASIONAL DRIVEN.......................UNRESTORED..................................MODIFIED...................................

74-2005 DRIVEN................................. MODIFIED DRIVEN..............................................

641/2-2000 WORK IN PROGRESS.........................................................

2006-2010  STOCK............................................... MODIFIED........................................ (THIS CLASS WILL BE AWARDED BY PARTICIPANT VOTES)

OTHER FORDS

PRE WORLD WAR II   STOCK................................................. MODIFIED..................................................................

1946-1959 STOCK......................................................................MODIFIED...................................................................

1096-1979 STOCK......................................................................MODIFIED..................................................................

1980- CURRENT STOCK...........................................................MODIFIED.................................................................

1903-CURRENT WORK IN PROGRESS.......................................................................................................................

PLEASE MAIL REGISTRATION AND CHECK TO: SUNCOAST MUSTANG CLUB C/O BILL DELLERT, 6705 CARDINAL DRIVE SOUTH, ST. PETERSBURG, FL. 33707-3803

MY SIGNATURE SAYS THAT I AGREE TO ABIDE BY ALL THE RULES OF THIS SHOW AND THAT I AM RESPONSIBLE FOR MY AUTOMOBILE AND/OR MERCAHANDISE. I AGREE TO RELEASE FROM ALL LIABILITY, THE MUSTANG CLUB OF AMERICA, SUNCOAST MUSTANG CLUB, AND ALL PARTICIPATING COMPANIES. I CERTIFY THAT I HAVE STATE REQUIRED AUTOMOBILE INSURANCE, A VALID DRIVERS LICENSE, AND THAT MY ENTRY IS IN SAFE CONDITION.

SIGNATURE.........................................................................................................................................................................................DATE.........................................................................

PHONE NUMBER..(.................)................................-.............................................