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* 1. Name

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* 2. Phone

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* 3. Email Address

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* 4. Car Make

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* 5. Car Model

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* 6. Car Year

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* 7. In consideration of the acceptance of the right to participate, entrants, participants and members of their party do hereby release and discharge Santee-Lakeside Elks Lodge, Troy Leezy, Caitlyn Braegelmann, and its event sponsors of any and all known and unknown damages, injuries, losses, judgments and/or claims from any cause whatsoever that maybe suffered by any entrant to his person or property. Further, each entrant expressly agrees to indemnify all of the forgoing entities, firms, persons from any and all liability occasioned or resulting from the conduct of entrants of any participant assisting or cooperating with the entrant under the direction or control of entrant. We reserve the right to refuse admittance to or to dismiss anyone for unacceptable conduct at our discretion.

I agree to allow pictures of myself and/or vehicle to be used in the publicity and advertising of this event.

By clicking the accept button, I agree to the above terms

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* 8. Please enter any comments or questions you may have (optional)

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