2021 Clutch Burners Picnic Form

Saturday, May 6, 2023 8 am - 4 pm

Dr. Powers Park - 900 W. Lowell Ave., Tracy, CA

ONLINE REGISTRATION WILL CLOSE AT MIDNIGHT ON 5/4/23.

You will be automatically directed to pay by debit, credit card or paypal after you submit this form. Thank you for participating!
Name:*

First NameLast Name
Phone Number:*

Area CodePhone Number
E-mail Address:*
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about us?*

Past ParticipantFacebookSaw Poster or FlyerFrom a FriendClub Member
VEHICLE TYPE
YEAR*
MAKE*
MODEL*
CAR CLUB AFFILIATION (if any)
Your Comments: please complete sign-up for each car entry
For additional information, please contact: Ernie (209) 346-3289 or Brad (209) 676-7433 or email: hotrods@clutchburners.com
LIABILITY RELEASE: In consideration of the acceptance of the right to participate; Entrants, participants and spectators by executing this registration form, release and discharge the City of Tracy and their officers, directors, employees, agents, representatives and servants and the Clutch Burners Car Club Inc. and their officers, directors and members and anyone else affiliated with the management of the presentation of “2023 Clutch Burners Picnic” of all known and unknown damages whatsoever that may be suffered by any entrant to his person or property. Further, each entrant expressly agrees to indemnify all of the foregoing entries, persons and bodies of and from any and all liability occasioned or resulting from the conduct of entrants or any participant assisting or cooperating with entrant and under the direct control of entrant.

NOTE: ALCOHOL PROHIBITED IN THE PARK PER TRACY MUNICIPAL CODE 44.16.050(f)

Event will be held rain or shine.
Signature (Required)*

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Note: To pay by debit or credit card, look below the PayPal login at checkout.
Car Entry: Please complete one for each vehicle*
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Picnic in the park registration$20.00
One vehicle participation on 5/6/23; Clutch Burners Picnic in the Park in Tracy, CA

Quantity

Total $0.00
$20.00 if paid by 5/4/23 / $25 if paid after 5/4/23

Includes picnic space, coffee and donuts.
Should be Empty:

Saturday, May 6, 2023 8 am - 4 pm

Dr. Powers Park - 900 W. Lowell Ave., Tracy, CA