The Region of DOOM�s 13th Annual
June 11, 12, and 13, 2010 . . . Rancho Cordova, CA
Name: (driver):____________________________________________________________________________
Shotgun:_________________________________________________________________________________
Other Attendees: (12 and over)_______________________________________________________________
Address:_________________________________________________________________________________
City, State, ZIP:___________________________________________________________________________
E-mail Address:___________________________________________________________________________
Telephone numbers:
Special Accommodations Needed:___________________________________________________________
Car Information: (check one)
___Impala ___SS Caprice ___other B-Body ___special interest (approved by RODarama Committee)
Year____________________ State___________________ License plate_____________________________
___Check here if you do not wish to have your car judged during the show-and-shine.
Each ($65) entry will receive a goody-bag.
Mail this form (with signatures of all adult parties attending affixed following the agreement at the end) along with the registration fee and payment for any additional shirts/caps to:
Region of DOOM
6645 Crystal Blvd.
El Dorado CA, 95623
Please make checks payable to Don Ishmael ROD.
Registration Deadline is May 28th, 2010. Any registration received after this date will be $80.00. Any additional guests, beyond driver and shotgun, 12 and over, riding in a registered car will be charged $17.00. Guest registration does not include t-shirt, baseball cap, dash plaque, or goody bag.
Number of T-shirts or Hats. Please write in the quantity in the blanks below:
T-shirts: SM___ MD_____ LG____ XL____ XXL____ XXXL____ XXXXL____
T-shirts are $16 each.
Baseball Caps:_______ One Size Fits All � $12 each. Quantities Limited!
Registration questions or comments? Please contact Don Ishmael at (530) 622-9596, email: [email protected]. Or contact Mike Rascher at (916) 420-1615, email: [email protected].
Visit our event website for the most up-to-date information: www.sacramentorodarama.com
Insurance: All registered vehicles must carry automobile liability coverage with minimum limits of $15,000/$30,000 bodily injury and $10,000 property damage. The undersigned acknowledges and understands that no insurance is available for coverage to the undersigned unless otherwise provided by private insurance obtained by the undersigned.
Entry and Advertising Release: In consideration of this entry, car owner (�Entrant�) and spouse/guests permit The Region of DOOM the use of their names and pictures, and pictures of their cars for publicity, advertising, and commercial purposes (including newspapers, magazines, Internet, radio and television) before, during and after the event and do hereby relinquish any rights whatsoever to any photos taken in connection with the event, and give permission to publish or sell or otherwise dispose of said photographs to The Region of DOOM. All publicity and advertising rights reserved by The Region of DOOM.
Liability: In consideration of the acceptance of the right to participate, entrant, spouse, and guests, by execution of this entry form, release and discharge The Region of DOOM, ISSCA., the State of California, the City of Rancho Cordova, the owners of any venue utilized for RODarama 2010 activities and their officers, directors, trustees, employees, agents, representatives, volunteers and servants, and anyone else connected with the management, sponsorship or presentation of RODarama 2010 of and from any and all known or unknown damages, injuries, losses, judgments, and/or claims, from any cause whatsoever, including the direct negligence of any and all persons connected with RODarama 2010, that may be suffered by entrant to his person or property. Further, entrant, spouse and guests agree to indemnify all of the foregoing entities, clubs, persons, and bodies of and from any and all liability occasioned or resulting from the conduct of other entrants or any participants assisting or cooperating with other entrants and under the direction or control of other entrants. Entrant, spouse and guests agree that participation in any contests, games, or activities may be limited.
Entrant must be 18 years of age. I have read this form and agree to all conditions of The Region of DOOM�s RODarama 2010 application and to rules governing the event, as set forth on this form, and agree to observe all rules and decisions of the event management.
_____ /____ /____ _______________________
Date Signature of Entrant
_____ /____ /____ _______________________
Date Signature of Spouse/Guest/Shotgun
_____ /____ /____ _______________________
Date Signature of Guest (age 18 or over)
_____ /____ /____ _______________________
Date Signature of Guest (age 18 or over)
_____ /____ /____ _______________________
Date Signature of Guest (age 18 or over)