All Wheels Weekend 2017 Registration Form June 16, 17, 18 2017 Name:___________________________________________________________________ Address:_________________________________________________________________ City:_________________________ State:__________ Zip:________________ Phone:_______________________________ Year:_______________________ Make:_____________________________ Model Car:________________________ or Model Pickup:_________________________ Color:_______________________________ Classification:_________________________________________________ Mileage to Dayton:_____________________________________________ Club Affiliation:________________________________________________ Number of Years Attended____________________________ Email Address_________________________________________________ NOTE: Full registration is for 2 people and 1 car only and includes 2 poker walk hands, 2 tickets to the demo derby, 2 Father's Day breakfasts, dash plaque, entry in the Show-N-Shine, and a Roll the Dice ticket. Show & Shine entries receive a dash plaque and are judged for a trophy, but do not receive entry to the demo derby or other events during All Wheels Weekend without paying individual admission fees. (*Dash plaques guaranteed to the first 350 entries.) REGISTRATION FEES
Early Bird Registration - Participants registered before May 26th will be entered in a drawing for a retro pedal car!
Full Registration until June 5th - $40.00 $________ No entry into drawing
Full Registration after June 5th - $50.00 $________
Show-N-Shine Only - Pre-Register - $20.00 $________
Show-N-Shine Only – Day of Show - $25.00 $________
Additional person - $10.00 each = $________
(Club participants must be pre-registered by June 5th.) I would like T-Shirts in sizes and/or hats as indicated: S
M
L
X L (circle one) - $15.00 $________
XXL XXXL (circle one) - $18.00 $________ Embroidered Hat - $15.00 $___________ TOTAL DUE: $___________ Mail registration form and check made payable to:
All Wheels Weekend 166 E Main Street Dayton, WA 99328 For more information call: Dayton Chamber of Commerce _______All Wheels Weekend Chairperson 1-800-882-6299 ____________________Bette Lou Crothers: 509-382-4444 or
[email protected] [email protected]
Registration packets can be picked up Friday night from 4 to 7 pm at First & Main or Saturday starting at 8 am in front of the State Farm Building on the corner of 1st and Main. Operation: Event management reserves the right to restrict behavior of all entrants. No burn-offs, loud exhaust or sound systems. Any violation is reason for eviction. There will be no refund of money if a participant is evicted. Liability: In consideration of your accepting my entry, I, intending to be legally bound for myself, my heirs, executors, and administrators, do hereby release and discharge the Dayton Chamber of Commerce, the All Wheels committee, all sponsors and supporters, and City of Dayton, Columbia County, and all other contributors from any and all liability arising from damages, illness, injury and/or physical consequences I may suffer as a result of my participation in this event. I understand that my entry fee is nonrefundable and that I must have proof of insurance. I have read the information provided and certify my compliance by my signature below. SIGNATURE:_________________________________________________ DATE:________________
Registrations will not be accepted without a signature.
Classifications 1. Restored Original Cars 2. Restored Original Pickups 3. Restoration in Progress 4. 10′s & 20′s Open Antique Cars 5. 10′s & 20′s Open Pickups 6. Original Pickups 7. Original Cars 8. Modified Pickups 9. Modified Cars 10. Custom Pickups 11. Custom Cars 12. 2000s Open Class Cars 13. 2000s Open Class Pickups 14. Street Rods 15. 4 x 4 Off Road 16. Open Motorcycles 17. Open Corvette 18. Open Mustang 19. Daily Driver 20. Rat Rod 21. Specialty Open Class 22. Open Bicycles 23. Open Dragster 24. 2010s Open Cars 25. 2010s Open Pickups 1. UNRESTORED ORIGINAL: The car is as it came from the factory. No restoration has been done to the car. No new paint, chrome, interior, etc. 2. RESTORED ORIGINAL: An attempt to restore to its original factory condition. 3. MODIFIED: An option has been put on that was not available in the factory but the body has not been altered, i.e. paint, interior material, tinted glass. 4. CUSTOM: A vehicle that the body has been altered in a major way, i.e. chrome removed, frenched, chopped or fiberglass