JR ENTERTAINMENT

REGISTRATION - Note: signed release of liability/hold harmless will be required upon arrival/entry. Forms will be provided at gate.

First name:

Last name:

Email address:

Club:

Mailing address:

PARTICIPATION INFORMATION

Year, Make, Model and Category OR Vendor Info:

Best way to contact you:

Please print and mail check to: JR ENTERTAINMENT P.O. BOX 224 PICO RIVERA, CA 90660

OR EMAIL REGISTRATION AND SEND COPY WITH CHECK FOR PRE-REGISTRATION DISCOUNT.

DISCOUNT APPLIES ONLY IF RECEIVED PRIOR TO EVENT DATE. Thank You!

EMAIL FORM TO: joe@picoriveracarshow.com