|   home                      ROD RUN APPLICATION  2012 n:schemas-. O. Box2010 99, Ca., 96009-4404 e-mail   39 Annual  Rod Run Application Open to all vehicles thru 1969. Limited to the first 150 entries. Entry includes: One vehicle, 2 adults, and their children 12 years and younger  July, 12 &13,  2013 Send to GVSR P.O. Box 994404 Redding, CA  96099-4404 ANY QUESTIONS CALL  Susie Ide at 530-275-5371 or Marty Jacobson at 530-221-5946 ------------------------------------------------------------------------------------------------------------ Name_______________________________________________spouse______________ Address_________________________________________________________________ City, State, Zip___________________________________Tel #____________________ Car Year______________ Make____________________ Model___________________ Club affiliation___________________________________________________________ e-mail address____________________________________________________________ Entry Fee: $55.00 per vehicle: Includes  Saturday lunch, Continental breakfast Saturday morning, Saturday lunch, Show and Shine, Poker Run, Saturday night dinner, Dash Plaque, and 1 T shirt  Raffle on Saturday,              Hot Wheel Races on Saturday Saturday only: $25.00 includes Show and Shine, Poker Run, and Lunch Please tell us the size for the free shirt ______________                          Quantity         Total Extra Dinners  $10.00 each        x       _______    =  _______ (6 year and under free) Extra T-shirts $12.50  s/m/l       x       _______    =  _______ Extra T-shirt  $14.50  xxl +       x       _______    =  _______ Registration Fee                                                        $55.00 Saturday only                                                              $25.00                               TOTAL  AMOUNT     =_________ Entrant Signature_________________________________________ In consideration of the acceptance of the right to participate, entrants, participants and spectators by execution of this form release and discharge GVSR, the city of McCloud their officers, directors, employees, agents or representatives, anyone else concerned with the presentation of the Volcano Run of all known and unknown damages, losses, injuries, judgments, and/or claims from any cause that may be suffered by entrants to his person or property. I understand and agree there will be no refunds