Vehicle Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Harrisonville Fire Company's Rods and Rails

What is your first name? *

What is your last name?
*

What is your phone number? *

What is your email?
*

What type of car, truck, or motorcycle are you planning on entering? (Brand/Model/Year) *

Is this vehicle stock? *

Yes

What type of modifications does it have? (If none, put N/A) *

What is the license plate number of the vehicle? (*Dealership Vehicles* Put DEALERSHIP NAME and VEHICLE PAINT COLOR) *

What state does the vehicle's license plate belong to? (*Dealership Vehicles* Put DEALERSHIP TOWN and DEALERSHIP STATE) *

There is a $10 donation per vehicle, do you plan to pay in advance or the day of? ("Day of" payments will ONLY be accepted in cash, failure to pay may result in your disqualification from the show and the exclusion of your vehicle in display) *

I plan to pay in ADVANCE (enter your address below)

I plan to pay the DAY OF (enter N/A below)

What is your address? (*ADVANCE PAYMENTS ONLY* We will send you a letter containing a bill for $10 that you can mail back payment as either cash or check) ("DAY OF" payments enter N/A)

[ROAD/PO. BOX, CITY, STATE, ZIP CODE]

Is your vehicle going to be shown in the show with a "FOR SALE" sign or with the intent of selling it? (All "FOR SALE" vehicles require an additional $5 donation on top of the $10 donation. (Failure to pay may result in your disqualification from the show and the exclusion of your vehicle in display.) *

Yes

TERMS AND CONDITONS:

Behavior:

Do you sign to the fact that you acknowledge that vandalism, theft, crime, or any actions that may damage property of the show hosts, guests, or spectators, the reputation of South Harrison Township, the reputation of the Harrisonville Fire Company, the reputation of the Rods and Rails event, or the reputation of its governmental entity guests may result in your removal from the show and/or grounds by show staff or law enforcement, if necessary. Furthermore, any possible criminal charges may be pressed against you.

Payment:

Do you sign to the fact that you acknowledge that ALL PAYMENTS ARE FINAL and are NON-REFUNDABLE.

Liability:

Rods and Rails event team, Harrisonville Fire Company, and South Harrison Township are not liable for any personal or government property you may bring, including but not limited to your vehicle(s). It is your sole responsibility to keep an eye on the property that you bring at ALL times as you are solely liable for any damages thereof.

*Typing your FULL legal name below is considered an electronic signature and as just as legally binding as a handwritten one.*

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Harrisonville Fire Company. Report Abuse

Forms