Apply

First Name*

Last Name*

City*

State*

Email*

Cell Phone*

For Texting only if needed about Show Updates

Vehicle Year*

Vehicle Make*

Vehicle Model*

Vehicle Category*

Show Primary Class*

This is your Primary Class. Below for an Extra $10 each, you can register for Additional Classes. Example: Camaro, add Convertible. Or Diesel Truck, add 4WD Truck, add All Original Truck.

Show Additional Class

This is your Secondary Class. Add an Extra $10 each, you can register for Additional Classes. Example: Camaro, add Convertible. Or Diesel Truck, add 4WD Truck, add All Original Truck.

Show Additional Class

This is your final Extra Class. Add an Extra $10 each, you can register for Additional Classes. Example: Camaro, add Convertible. Or Diesel Truck, add 4WD Truck, add All Original Truck.

Total Entry Fee*

Please add the Total Entry Fees and type in the field above

Young Gun

Must be under 30 and can provide proof if requested

Veteran

Must be an active duty or retired Veteran from any of the US Armed Forces

Upload a Pic of Your Vehicle Below

This is not required. We are trying to build a database of all our car show participants and the vehicle's they own.

Education Level

Demographic Research - Fill out if you wish

How Many Cool Vehicles do you own

By checking this box, I agree that as a participant in this event, I do not hold the Promoters, their staff or its Sponsors responsible or liable for any damage to my vehicle or theft of personal property. I agree that no illegal, drugs or weapons of any kind will be permitted on show site premises and agree that I may be detained or arrested by law enforcement and subject to all the laws applicable. As such, I will forfeit all entry fees and I may be disqualified from this event and barred from any future events held by Heartland Rod & Custom, Full Throttle Customs or RodandCustomShows.com. All vehicles will be directed to their designated parking spaces by Show Staff. Failure to do so can result in forfeiture from balloting or judging. Entry fees will not be refunded due to non-compliance of parking. No vehicle will be allowed to exhibit music beyond the confines of their vehicle area without express consent of the Show Promoter. Music has been provided for the enjoyment of both participants and spectators. This is a first warning, if we need to ask a second time, dismissal from the show can result. Any vehicle driven in an unsafe manner, such as burnouts, or speeds over posted limits will result in law enforcement intervention and possible ban from future events by the promoter. Pictures are taken of all the vehicles and may be used in future marketing to promote other shows. By signing this entry, Heartland Rod & Custom, Full Throttle Customs, RodandCustomShows.com is being given permission to use your vehicle’s picture for promotional use only in the future marketing of its shows. Thank you for your cooperation. PLEASE ENJOY THE SHOW.Does Not Accept

Signature