make checks payable to

Fred Gibb Memorial Car show  c/o Kenny Brown 107 Monmouth Rd

                                                           Laharpe, Illinois 61450

 

Name__________________________________________________

Address________________________________________________

City_________________________State_____Zip_______________

Entry Class____________Year_______Make______Model________

 
I hereby release the sponsors of this event, the City of LaHarpe and all of the event staff from
any responsibility in case of accident to myself or my vehicle and its contents.

 

 

Signed____________________________________Specify T-Shirt size______________

 

 

 

Need info: Kenny Brown nopgw@winco.net