Cruisin' To Rosanky Car Show
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Jarrett - 512-332-1833

...a ministry of Rosanky Baptist Church
Registration Form:  Cruisin' To Rosanky Car Show
Please Print Form out and Submit Payment written to RBC Youth Ministries: in the memo: Car Show.   
*And mail completed form and check to: RBC Car Event /P.O. Box 96/ Rosanky, TX 78953

Name:________________________________________ Class:_____________________ Shirt: M L XL 2X 3X

Address:___________________________City:_______________________ State:____ Zip:__________

Cell Phone:_____________________________ E-Mail Address:_____________________________________

Year:____________ Make of Car:_______________ Model:____________________ Color:_________

Classification:_______________Club Affiliation (if any):______________________________________

In consideration of the acceptance of the right to participate, registrants and accompanying person release and discharge Rosanky Baptist Church, its officials, members, agents, representatives and anyone else connected with management or presentation of this event of and from any and all known or unknown damages, injuries losses, and/or claims from any causes whatsoever that may be suffered by a registrant, or their accompanying person, to his/her property.

Sign Here X___________________________________________________ Date: _________________________

Registration: $20.00 First 30 registrations get free t-shirt                            

Definitions of Classification:

Original – defined as same horsepower engine and unaltered body style

Modified – defined as change in horsepower and or altered body style

Survivor – unrestored original recognized by Bloomington Gold Rules as at least 20 years old and judged to be more than 50% unrestored, yet with finishes, surfaces, and overall condition good enough to use as a reference for authentic restoration of a similar vehicle.



City_________________________________________________State:___________  Zip:_______________

Day Phone:______________________________Evening Phone___________________________________

Type of Product or Services Offered:_________________________________________________________


__________ Space(s) at $20.00 each for a total of $_________ Please reserve__Side/Side or _____Back/Back


Vendor Setup is October 9, 2015 beginning at noon