Northern Indiana Lakes British Motor Club

Warsaw, Indiana

Spring Rally 2011 Registration Form

Event Date: August 13th, 2011

Location: Start at Center Lake Pavillion Time: 12:30PM registration, 1PM event start

Cost: $10 per car

Will finish up at Dave & Carol Kalps’,  7822 E Via Del Sogno, Fort Wayne IN 46818
(Dunfee, Indiana on County Line Rd, North of SR14)

Carry in Dinner starts about 5:30pm. Dogs, brats & burgers provided, bring a dish to share.
Bring your favorite beverages. Participants, Kalps will transport perishable items from start to finish.

Name

 

 Name of Team:
(be creative!)		  

Car Make / Model

 

Year

 

Mailing Address

 

City, State, Zip Code

 

Phone Numbers

 

Email Address

 

 

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

 

 

Once you have completed this form:

Print out, fill out, and bring with check to event. Contact us at NILBMC@gmail.com

For more info contact: bruce@woodward-realty.com | Phone:  574-551-1133

                Northern Indiana Lakes British Motor Club | PO Box 665 Warsaw, IN 46581-0665 | www.NILBMC.org