Car/Truck/Motorcycle Registration Form
Event Date: September 20, 2020
Event Times: 9:30 AM to 3 PM
Event Address: 901 Michigan Avenue, La Porte IN 46350
Contact Michelle Corrigan at (219) 325-9622 or mcorrigan@lpymca.org
Email address *
Name *
Address and Contact Phone Number *
Organization (if appropriate)
Entry Information (check one of the following): *
Required
Year: ______________ Make: __________________ Model:________________ Color: _____________ License Plate#:____________________ State:___________ *
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