Registration Form

 

 

Name _______________________________________Phone # (_____)______________ Age______

                                                                                                                                                         (If under 18)

Address ________________________________City___________________ State_______ Zip_______

 

Car Entry Description:

 

1st  — Entry:       Year  ________  Make _________________________  Model _____________________

 

2nd — Entry:    Year  ________  Make _________________________  Model _____________________

 

3rd — Entry:    Year  ________  Make _________________________  Model _____________________

 

Registration Fees:   First Entry    $20            Each Additional Entry  $15

 

                     Dandelion Daze 2013 Awards

 ¶ Top 15  Top Gun (Rodder’s Choice)  People’s Choice 

                                                                    

ü      Registration: Saturday, June 15 — 8:00 to 11: 00 a.m. — Phillips County Courthouse Lawn

                            (1 Block South of Highway US 385 & CO 6 Intersection)

 
                   ã Lodging in Holyoke  ã

=Golden Plains Motel  800-643-0451               =The Burge Motel  970-854-2261

                          =Joy’s Cozy Cottage & RV Parking  970-854-3308           

=Campgrounds / RV Parking / Motor Homes: Phillips County Fairgrounds  970-854-3778

 

My signature below hereby waives and releases the Dandelion Daze Committee, the Holyoke Chamber and
anyone else connected with the management or presentation of the Dandelion Daze Car Show, from any
liability for any injuries, illness, damages, or judgments that may occur during this event. Management
reserves the right to remove any entrant or his/her vehicle if appearance or conduct, is deemed objectionable.

  
 

_____________________________________        _______________________________________

Signature                                                   Guardian’s Signature (if under age 18)

 

                TOTAL AMOUNT ENCLOSED: $_________________  (Fees are Non-Refundable)

 

                      Mail Registration and Entry Fee(s) to:

Holyoke Chamber of Commerce  > P.O. Box 134 > Holyoke, CO 80734