Florence Car Show Registration Form

Car Owner Name

First NameLast Name

Car Owner Email*

This is the ONLY way we communicate with you.

Car Owner Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Year

Car Make

Car Model

Color

$40 Pre-Registration is REQUIRED*

Pre-registration Fee includes 1 t-shirt and a dash plaque!

ONLY SELECT ONE SIZE, PURCHASE ADDITIONAL T-SHIRTS BELOW. T-shirts are MEN'S SIZES.

$40.00

Size	Quantity
S
M
L
XL
XXL
XXXL

Item subtotal:$0.00

Additional T-shirt(s)

Specify Men's Size(s)

$25.00

Size	Quantity
S
M
L
XL
XXL
XXXL

Item subtotal:$0.00

Extra Dash Plaque(s)

$5.00 Quantity
Item subtotal:$0.00

Total

$0.00

Credit Card

Emergency Contact Person*

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

AGREEMENT, WAIVER AND RELEASE

In consideration of being permitted by the Florence Merchant’s Association and the City of Florence to participate in the Florence Merchant’s Association Car Show, I hereby waive, release and discharge any and all claims for damage for personal injury, death or property damage, and any and all other claims I may have, which I may have, or which may hereafter accrue to me, as a result of participation in the above activity. This release is intended to discharge in advance the City of Florence and the Florence Merchant’s Association its officers, employees, elected officials, and agents from any and all liability arising out of or connected in any way, including COVID exposure, with my participation in the above activity even though that liability may arise out of negligence or carelessness on the part of those parties. It is understood that activities such as the ones I will be participating in involve an element of risk and danger of accidents and knowing those risks, I hereby assume those risks. It is further agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns. I agree to indemnify and hold harmless, the City of Florence and Florence Merchant’s Association, its officers, employees, elected officials, and agents from any loss, liability, damage, cost or expense which they may incur as the result of my death or any injury or property damage that I may sustain while participating in this activity.

I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE CITY OF FLORENCE AND FLORENCE MERCHANT’S ASSIOCIATION AND I SIGN IT OF MY OWN FREE WILL.

THE CITY OF FLORENCE DOES NOT WAIVE OR INTEND TO WAIVE ANY PORITION OF IMMUNITY PROVIDED BY THE COLORADO GOVERNMENTAL IMMUNITY ACT OR OTHERWISE.

Car Owner Signature

Date Signed

Date

Florence Car Show Registration Form

Car Details

Payment Details

Credit Card