Please Print, Fill & Mail:
Date: Email:
Name:
Address: City: ST : Zip:
Email___________________________________________
| Year | Make | Model | Body Style | Class | |
|---|---|---|---|---|---|
Registration Fees:
Antique Car $15.00 $ ____
Second Car $10.00 $ ____
MOTAA Membership Dues @ 30.00 No. __ $ ____ Required
TOTAL AMOUNT DUE $ ____
Insurance Carrier
The decisions of the Head Judge will be final, and no scored judging sheets will be provided to the registrants.
I Hereby release MOTAA and all its members and The Museum Of Automobiles, Inc. from any and all liability.
MOTAA Member No. Signed
Please Print, Fill, & Mail to:
MOTAA Petit Jean Mountain 8 Jones Lane Morrilton, AR 72110