1999 Concours d'Elegance, Registration

1999 Concours Registration Form

Name : __________________________________________

Address : __________________________________________

__________________________________________

Club affiliation : __________________________________________

JCNA # : ____________

JCNA classes 1 - 19 (First Entry $ 40, each additional $ 35) :

Model :___________________ series : ____________ year : _____

Total $ :

Driven classes (each entry $ 40) :

Model :___________________ series : ____________ year : _____

Total $ :

Display classes (each entry $ 40) :

Model :___________________ series : ____________ year : _____

Total $ :

Trailer space needed :_____

Release statement :
In consideration of the right and priviledge to enter and participate in the event, I agree to release and hold harmless Mizner Park, the South Florida Jaguar CLub, Jaguar Clubs of North America and the concours committee, from any and all liability for injuries, damages and loss arising from my entry attendance and participation in the 1999 Concours d'elegance.

Date: __________ Signature : _______________________

Please mail this form with payment (payable to South Florida Jaguar Club ) to

Mike Rosenberg
520 NE Phillips Dr
Boca Raton, FL 33432

a JCNA sanctioned event, sponsored by
Alpine Jaguar