Member Registration
$50 per car - Each registration completed by May 18th includes two lunches
DRIVER'S INFORMATION
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Does the Driver have any dietary restrictions?
PASSENGER'S INFORMATION, if applicable
First Name
Your answer
Last Name
Your answer
Email
Your answer
Phone Number
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Does the Passenger have any dietary restrictions?
VEHICLE INFORMATION
Year: *
Your answer
Make: *
Your answer
Model: *
Your answer
Payment Method: *
Release of Liability and Consent Form
Your electronic signature below indicates: (1) the above signed participants hereby assume all of the risks of participating in any/all activities associated with this event, including by way of example and not limitation, any risks that may arise from negligent or careless vehicle operation or dangerous and/or defective equipment; (2) participants understand that they may be photographed and/or filmed and that their likenesses may to be used for any legitimate purpose by OHTM; and (3) the Driver acknowledges that the vehicle listed above is properly registered and insured for road use. If you agree to the above terms and conditions, type your full name below. *
Your answer
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