JEEPTOBERFEST 2017 Last_ First_ Name Address_ City State Zip_ Phone E-Mail_ of Jeep Year/Make of Jeep Please do not share my name and address The Ocala Jeep Club would like to share your contact information with our sponsors so that they can keep you By checking this box, I hereby expressly withhold my consent informed of special offers they may provide to show to any disclosure or dissemination to third persons of the participants. information supplied by me in this registration form. Pre-Registration: $50.00 Registration at Gate: $70.00 per Jeep Payment: (Please Circle One) Cash Check **-Price is PER JEEP & includes all days of the Event-** Make Checks payable to JEEP CLUB T-Shirt Size: (First 600 pre-registered entries received before October 14th will receive a free commemorative and goody bag.) Name of 4WD Club(s) that you are a member of: Pre-Registration forms MUST be submitted by October 14, 2016 For more information, please contact or visit jeeptoberfest.com A Liability waiver must be submitted with your registration form - See reverse side NO ALCOHOL NO PETS NO ALCOHOL
JEEPTOBERFEST 2017 Name Last_ First_ Address_ City State Zip_ Phone E-Mail_ Year/Make of Jeep of Jeep The Ocala Jeep Club would like to share your contact information with our sponsors so that they can keep you informed of special offers they may provide to show participants. Please do not share my name and address By checking this box, I hereby expressly withhold my consent to any disclosure or dissemination to third persons of the information supplied by me in this registration form. Pre-Registration: $50.00 Registration at Gate: $70.00 per Jeep Payment: (Please Circle One) Cash Check **-Price is PER JEEP & includes all days of the Event-** Make Checks payable to JEEP CLUB T-Shirt Size: (First 600 pre-registered entries received before October 14th will receive a free commemorative and goody bag.) Name of 4WD Club(s) that you are a member of: Pre-Registration forms MUST be submitted by October 14, 2016 For more information, please contact or visit jeeptoberfest.com A Liability waiver must be submitted with your registration form - See reverse side NO ALCOHOL NO PETS NO ALCOHOL
2017-Paper-Registration-Form-with-Waiver.docx