Registration Form
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Email *
Car Make, Model, Year *
name *
Phone number *
Address *
City *
State *
The undersigned participant assumes all risks and responsibilities of possible damage or injury involved through my participation in this activity. I understand that I am to furnish my own insurance in case of injuries or damage to my vehicle. I further release, indemnify and hold harmless Perkasie Borough, their officers, agents, employees and assigns from liability for personal or property damage.
SIGNED *
DATE *
MM
/
DD
/
YYYY
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