NORTHERN INDIANA LAKES BRITISH MOTOR CLUB

WARSAW, INDIANA

Fall Out 2008 Registration Form - Event date October 4, 2008

Winona Lake, Indiana - 10 AM registration opens, 3 PM awards

Cost: $15 Preregister up to October 1st, $20 day of show


Name Car Make & Model Year


Address
City St & Zip

phones:
email address:


Club Membership:

WAIVER: I am aware of the hazards with motor vehicle events and specifically release and indemnify the organizing club and The Village at Winona, collectively and separately, from any and all liability from personal injury or property damage incurred by me or by my guest(s) while participating in this event. I have read, understand and agree to this release.

SIGNATURE: ____________________________________________DATE: ______________

Print out, fill out, and mail with check to: NILBMC Treasurer, P.O. Box 665, Warsaw, IN 46581

Contact us at: nilbmc@hotmail.com

for registration info contact: bruce@woodward-realty.com

phone: 574-551-1133