Name:
Address: City: State: Zip:
Phone: - Email:
Make: Model: Year: Low-Rider Hydraulics Street Rod Stock Original Street Machine Pickup Full Pickup Mini Corvette Antique (Pre 43) Muscle (2 mods or less) Unfinished (Primered) Special Interest Custom
Pre-Registration is $12.00 Day of Show $15.00 You save 20% Check must be received by June 15, 2002 for discount, made payable to: JC Cruisers PO Box 92 Rensselaer, IN 47978 Have you shown here before? Yes No
