Concord Mall Car Show Hosted B

The Familia Car Club

We are not just a club, we TM

are Family 2017 Car Show ENTRY Form
Date: Saturday June 17, 2017
Location: 3701 South Main Street, Elkhart, IN 4
Event Hours: 1:30pm 9:00pm
Prime Leasing & Sponsorship Deborah Alwine .
Prime Host Jorge Millan
Car show registration forms would be provided at the en
Your Contact ( Please print clearly
)

Name

Car Club (if attending with a car club)

Phone Mobile Phone

Vehicle Year Make Model

Registration One form per vehicle. Car clubs: Please combine all your entry forms into
one submission. Approximately half of each entry fee goes to community
nonprofit organizations.
Preregistration Cars and Trucks: $15 (Day-of registration: Add $5, subject to
space availability.)

Preregistration Motorcycles: $10 (Day-of registration: Add $5, subject to space

availability.)

Price on Date of The Event - $5.00 per person, Kids enter free (12 and down)

Required Waiver of Liability, Release, and Payment Information

On behalf of the entire group participating in the 2017 Concord Mall Car Show, I assume all risk of bodily injury,
property damage, and personal damage that may occur by participating in the Concord Mall Car Show and, for
myself/ourselves, their heirs, executors, and administrators, do hereby forever waive and release any and all claims
against and agree to hold harmless The Familia Car Club, and the Concord Mall Car Show. Its committee, sponsors
and volunteers, and the County of Elkhart with their respective officers, employees, agents, representatives,
volunteers, successors or assigns any kind from any and all claims which may be made for any cause whatsoever
arising as a result of participation. Further, I hereby consent to allow my picture or likeness to appear in any official
document, news release, sponsor advertisement and/or television and radio coverage of the events within or as part
of the Concord Car Show, and grant permission to use and/or publish photographic portraits, or pictures, video tape
or film of me in which I may be included in whole, part, composite or reproductions thereof in black and white and/or
color or otherwise made through any media now known, for art, advertising trade or any other similar lawful
purposes whatsoever, including the publicity and promotion of this event itself, excluding commercial use of or by
marketing sponsors.
Print Name
(If on a club car, please allow the leader of your car club to sign as he will be
responsible for the whole group)
Signature

For car club registrations questions, please call or text at

(574)349-3523 or (574)226-4921.

General Questions? Contact us at (574)349-3523 or Jorge_millan14@icloud.com

Categories/classes
Rules and Guidelines:
1. Best Car Club Representation
2. Limbo Contest Bagged
3. Ugliest Car ! NO BURNOUTS! You will be banned from
4. Peoples Choice the event and any future meets or shows!!!
5. Best Imported Motorcycle Dont lean or sit on anyones car
6. Best American Motorcycle Diesel trucks dont blow smoke
7. Best Interior Dont rev your car in the parking lot as we will
8. Best Custom have people walking around.
9. Best Engine Bay Pick up your trash to keep place clean.
10.Best In Show Please watch your kids at all time.
11.Best Classic When arriving the event, please follow
12.JDM Award directions on where to park, we have a lot of
13.Best Muscle space so if saving a spot for friend let us know
14.Best Air Ride Setup we will allow a 10 min wait time.
15.Best Ford NO ALCOHOL!!!!
16.Best Exotic
17.Best Wheels
18.Best Import
19.Best Mini Truck We will have security on premises and the Elkhart
20.Best Lifted Truck Police Department & Elkhart Sheriff Department will
21.Best Diesel be notified of the event.
22.Furthest Traveled
23.Best Hatchback
24.Best Womens Car
25.Best 4 Cylinder
26.Best V6
27.Best V8
28.Best Mopar
29.Best GM
30.Best Sound System

CATEGORY SIGN UP SHEET

Category Vehicle Year Vehicle Make Vehicle Model VIN #
Name