NASS NWST2007 Spit-together Information

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2007 ABFM Entry Form

Please complete all information on form and then print completed form. Sign the completed and printed form, then send/fax to address/fax# at bottom. To qualify for the Early Entry Drawing your entry must be post marked or faxed by June 28, 2007

Name __________________________________________________
Second Name ____________________________________________
Address ________________________________________________
City __________________State________ Zip/Postal______________
Phone Fax Club __________________________________________
Email___________________________________________________

Vehicle Information (Classes will be determined by number of entrants)

1st Vehicle entry will receive a Dash Plaque, Souvenir Program with Pre Registration Only. Pre-Registration deadline is Wed. July 25, 2007

Make, Year, Model, Color, Body Style

1_________________________________________________________
2_________________________________________________________
3_________________________________________________________
4_________________________________________________________

Regalia (Enter Qty)

Tshirts M ___________L__________ XL__________
Tshirts XXL__________ XXXL_________

Fees

Item Qty Price Sub-Total

First Vehicle                 ____________         $30.00            ____________
Additional Vehicles       ____________        $15.00             ____________
Breakfast and Drive       ____________        $10.00            ____________
First Swap Meet Space ____________        $35.00           ____________
Additional Swap Meet Space ________        $20.00           ____________
For Sale Space              ____________        $35.00           ____________
T-Shirts MXL                ____________        $18.00           ____________
T-Shirts XXL-XXXL     ____________        $20.00          ____________
Dash Plaque                   ____________          $6.00          ____________
Grill Badge (Triumph)     ____________        $39.95          ____________

TOTAL ______________________

I agree to insure my vehicle against loss, damage, and liability. I agree to assume the risk of any damage or injury, and to indemnify and hold harmless The Puget Sound British Automotive Society, its officers, and directors or agents for any acts of omission which may result in the theft, damage, or destruction of my property or injury to me or others occurring during or as a consequence of this meet including but not limited to: overnight storage, and all places associated with this meet.

Signature:______________________________________Date:_____________

Payment Method

All payment must be in US Funds. Please make checks payable to Puget Sound British Automotive Society (PSBAS) Mail printed form to Arnie Taub 17610 NE 8th Place Bellevue WA 98008 Your Entry Form & Credit Card information can be sent by FAX to: (425) 747-0205

Check Visa____ Mastercard____
Card Number_______________________ ExpDate_________
Signature____________________________________________

There will be no refunds or cancellations within 14 days of the event. All entries received prior to July 1st will be confirmed.

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