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Machines Car Show Registration

*Number of Seats
Thank you for participating in this year’s MEN & MACHINES CAR SHOW!

Please fill out the following form for each vehicle entry. (The $25 fee per vehicle is to be paid the day of the show. Or make a check payable today to Benefis Foundation and mail to: Benefis Foundation, ATTN: Car Show, 1101 26th Street South, Great Falls, MT 59405)

NOTE: By submitting this form, you release Benefis Health System, Benefis Sletten Cancer Institute, its affiliates, staff and volunteers from any and all damages, injuries, losses or claims suffered by entrant to his person or property.


* Denotes required field
 Date: Saturday, September 9, 2016  
 Time: 10 a.m. - 3 p.m.; registration begins at 7 a.m.  
 Cost: $25 minimum gift per vehicle
 
*Name:
*Address:

*City:

*State/Province: ]


*Country:

*Zip Code/Postal Code:

 
*Phone Number:

*Email:
*Make:
 
*Model:
 
*Year:  
Other Info:
 
*T-Shirt Size (xs-XXX):
 
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