SCRAPE by the LAKE 2010
Name:_____________________________________ Age:______
Address:___________________________
City:______________
Prov/State:_____
Postal/Zip:_________ Email:______________
Club Affiliation:__________________Phone:
( ) __________
Vehicle:
Year______ Make___________ Model ____________
(Circle all that apply) car
truck suv sportbike
Pre-Registration – Show $50 (day of show $60)
Show-n-Shine - $30 (day of show $40)
(Show-n-Shine vehicles will NOT be
judged)
Deadline to pre-register :
Friday July 9th (online July 14th)
Make cheque/money order payable to: 1211861 ONTARIO INC.
And mail with this form to:
Scrape by the Lake
4696 Bartlett Rd. Suite #3, Beamsville, ON L0R 1B1
Approval: All entries are subject to approval by Scrape by the Lake staff. Entry fees (day of show): $60 per
vehicle ($20 per lowrider bike) and are non-refundable unless entry is refused
by SBTL staff. Liability: Scrape by the Lake, Faction Sales Unlimited, sponsors, Prudhommes Landing and Prudhommes Inn assume no liability or responsibility for
any theft or damage of vehicles, displays and related items during show hours.
By signing below you acknowledge that you have current vehicle insurance that
includes car show attendance. Safety: All hydraulic equipped vehicles
must have proper disconnect kills, and a regulation
fire extinguisher. All show vehicles may be moved into the show, to the judging
lanes, and out of the show only. Park
Damages: Entrants will be held responsible for any damages that may occur
from the movement of said vehicle. Alcohol:
No alcoholic beverages are permitted in the show area and violators will be
removed from the event. Photos/Videos: As a registered participant of
Scrape by the Lake, you agree to the use of images and/or
video of the above registered vehicle and/or person. These images/video will be
used solely for the purpose of
documentation, promotion and advertising for past/future Scrape by the
Lake shows, and will not be sold/rented/loaned to any outside source for any
reason. Information: As a registered participant of Scrape by the Lake, you agree to the use of the above registration
information by Scrape by the Lake staff, for
Scrape by the Lake events only. Above information will not be
sold/rented/loaned to any outside source for any reason. As an entrant to the
Scrape by the Lake
Custom car show, I hereby
agree to the above stipulations and regulations set forth. By signing below, I
acknowledge that I have read and understood the above release, and understand
my responsibilities. Pre-registrations are NON-refundable! This event is RAIN
or SHINE – no refunds.
Signature_________________________Date_________Witness______________