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   Car  Number


______________
Loveland Kruzers
PO Box #1
Loveland, Ohio 45140
Name_______________________________________________________________
address.
___________________________________________________________________
City, State, zip ___________________________________phone __________________
Tell us about your Car:________________________________________________
  manufacturer________________   Model   _________________      Year ________
color.    ______________________              interior ________________________                         
Any  Interesting story,   or unique  features of your car:
__________________________________________________________________________________
_________________________________________________________________________________
. _______________________________________________________________________________
CLUB   AFFILIATIONS ____________________________________________
The Loveland Kruzers have my permission to reproduce my image
  and that of my vehicle
                                    __________________________________________                 
Date  _____________
Not responsible for loss  due to  Injury,  Theft ,  or accident
                               
                                 Loveland Kruzers  -  PO BOX #1
                                    LOVELAND, OHIO 45140
                                          Registration  $10.00 

                 
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