27th Annual Antique Truck Show & BBQ Saturday April 28 2012 At Kirkland Ranch Gates open @ 6am Friday & Saturday for Truck Unloading & Parking For More Info Contact Dennis Chan at 916-381-6063 Email dchan@redi-gro.com Send This Form and Check Payable to Central California Chapter ATHS To Emogene Thomas 321 Paloma Court Martinez,CA 94553 925-228-5483 My signature below acknowledges and certifies that my vehicle owned or operated by me in any ATHS sanction event is covered by Primary Individual Liability Insurance, is in safe working order, and complies with all applicable regulations. The vehicle operator is competent to drive the vehicle, and holds a valid driver's licence. I understand and agree to abide by all ATHS Antique Truck Show safety rules. Each Registration Fee Includes One Dash Plaque and covers all trucks brought to the show. There is no extra fee For Additional trucks. Need a RV Space? Yes______No______ Description Of Vehicle Year Make Model Body Style Overall Length ________ _________ _________ _____________ _____________ ________ _________ _________ _____________ _____________ ________ _________ _________ _____________ _____________ Truck Registration $10.00 $__________ Saturday BBQ Dinner _____ @ $17.00 Each = $__________ Children Under 12 ________ @ $ 7.00 Each = $__________ Sunday Brunch __________ @ $ 6.00 Each= $__________ Additional Dash Plaques _____@ $5.00 Each =$__________ ____ Total $__________ Signature_________________ Date___________________ Name____________________________________________ Address__________________________________________ City_______________________State______Zip__________ |
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