Livermore DAZE Car Show Registration

Livermore DAZE Car Show Registration 2008

(Fields in bold are required)

First Name:
Last Name:
Address:
City:
State (US only)
Zip/Postal Code:
Voice Phone:
E-mail Address:
Make:
Model:
Year:
Class:
I accept and assume full liability for any loss or injury to me or my property, agent, and employees at anytime and from any cause on the premises of this car show. I expressly release the Livermore DAZE Committee and the City of Livermore from any liability for such lose or injury and agree to provide and pay for my own insurance.