Entry Number  

Emerald Coast Cruizin

November 3 – 8, 2008

Pre-Registration Before September 31        $40.00

After September 31, show only registgration  $45.00

ENTRY FORM

(PLEASE PRINT)

Name: _________________________ E-Mail: ____________________________

Address_______________________ City___________________ State:_____Zip:________

Phone:________________________  Insurance Carrier: ____________________________

Vehicle Make: ________________Year: ____________ Model: __________________­­___

Signature:____________________ Date:____________________________

    Please make checks payable to Emerald Coast Cruizin Post Office Box 361, Ripley, MS  38663

                                                                 Phone: 662-587-9572

www.emeraldcoastcruizin.com

Confirmation Cards will be mailed out starting in July, your packet can be picked up at the show with your Confirmation Card.

Entry and Advertising Release:  In consideration of this entry, car owner and spouse/guest agree to permit Emerald Coast Cruizin, the use of their names and pictures, and pictures of their cars for publicity, advertising, and commercial purposes (including newspapers, magazine, radio and television) before, during and after the event and do hereby relinquish rights to any photos taken in connection with the event, and give permission to publish or sell or otherwise dispose of said photographs to Emerald Coast Cruizin.  All publicity and advertising rights reserved by Emerald Coast Cruizin.

Liability:  In consideration of the acceptance of the right to participate, entrants, and participants, by execution of this entry form, release and discharge Emerald Coast Cruizin,  the state of Florida, the Bay County Division of Tourism Bureau, the City of Panama City Beach, Emerald Coast Cruizin and their officers, directors, trustees, employees, agents, volunteers, sponsors, organizers, promoters, and servants, and anyone else connected with the management or presentation of Emerald Coast Cruizin, of and from any and all known or unknown damages, injuries, losses, judgments, and or claims from any cause whatsoever that may be suffered by entrant to his/her person or property.  Further each entrant expressly agrees to indemnify all of the foregoing entities, firms, persons and bodies of and from any and all liability occasioned or resulting from the conduct of entrants or any participants assisting or cooperating with entrants and under the direction of control of entrants.  Entrants agree that participation in any contest, games, or activates may be limited.

Eligibility:  Emerald Coast Cruizin is open to all qualified vehicles.  Entrant must by 18 years of age.  I have read this form and agree to all terms and conditions of the Emerald Coast Cruizin application and the rules governing the event as set forth on this form and agree to observe all rules and decisions of the event management.