San Gabriel Valley Chapter - Buick Club of America

Saturday, May 2, 2009 Buick Show Registration

DATE SUBMITTED ___/___/___BCA# _________________BCA EXPIRATION DATE ______/______/________

NAME____________________________________SPOUSE ___________________________________

ADDRESS ________________________________ CITY STATE ZIP (+4) ____________-____________

TELEPHONE (___)___-_________ Email address ____________________________

Year _________________ Model __________ Body style __________ Notes (Orig, Restored, Mod, Wk in Prog) _________________
Year _________________ Model __________ Body style __________ Notes (Orig, Restored, Mod, Wk in Prog) _________________
Year _________________ Model __________ Body style __________ Notes (Orig, Restored, Mod, Wk in Prog) _________________
Year _________________ Model __________ Body style __________ Notes (Orig, Restored, Mod, Wk in Prog) _________________

The show has moved to Crescenta Valley Park - 3901 Dunsmore Ave, Glendale 91214
Pre-1923 cars are FREE
Early Registration until April 20: Show cars $15 each, Swap space and cars for sale - $20 each
After April 25: Show cars $20 each, Swap space and cars for sale - $20 each
Number of Swap Spaces _________ Number of Cars for sale _________

Checks payable to: San Gabriel Valley Chapter - Buick Club of America P.O. Box 2355 Pasadena CA, 91102-2355
HOLD HARMLESS AGREEMENT: ENTRANT AND ALL GUESTS HEREBY RELINQUISH ALL CLAIMS THAT MAY ARISE AGAINST THE
BUICK CLUB OF AMERICA AND ITS CHAPTERS DURING ATTENDANCE AT THIS EVENT.
THIS RELEASE MUST BE SIGNE BY ALL ENTRANTS

NAME_____________________________ DATE ________________

FOR MORE INFORMATION CALL JOHN LARSON: (626) 590-0523 OR EMAIL JLARSON@SOCAL.RR.COM

Email for information: jlarson@socal.rr.com