MOPARS IN THE MOUNTAINS
584 3A Street NW
CRANBROOK, B.C. V1C 6T7
250-426-8811
4th Annual Show & Shine
J U L Y 1 7, 2 0 1 0
Name: ________________________________
Address:______________________City________________Province/State________
Phone: ( ) _____________________
E-Mail:_____________________________________
Year: ___________Make:______________
Model: _______________Colour_____________
$20.00 registration fee
As a participant in the Annual Mopars In The Mountains Car Show and Shine and any activities held in conjunction with this event: I hereby release the City of
Dated at ______________This _______day of ____________2010
__________________________
Signature of Participant