Delray Beach Concours D'Elegance Vehicle Entry
Delray Beach Concours d'Elegance
Saturday June 18, 2022
11 AM - 4 PM
SE 2nd Ave from SE 1st St. to SE 3rd St. (2 Blocks)
200 SE Second Avenue, Delray Beach FL 33444
www.DelrayConcours.com

Free Public Family Friendly Event
Cars AND Motorcycles!
*Individual Form Per Vehicle
$100 Vehicle Entry Fee

Proceeds benefit 4 Delray Nonprofits:
- Achievement Center Children and Families
- Community Classroom Project
- Community Greening
- & Delray Citizens for Delray Police.

Online Registration & Payment Deadline: June 1, 2022.
Payment & event info via www.DelrayConcours.com/car-entry

ONE DAY EVENT - SATURDAY JUNE 18
Set Up/Car Arrival: 8-10 AM – Clean Up/Departure 4-6 PM

Please find the Paypal link to complete the Car Registration Payment - http://www.delrayconcours.com/car-entry - (Include your Name, Car Year & Model in payment)
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Vehicle Usage Agreement
This Vehicle Usage Agreement (“Agreement”) is between Flying From Delray, LLC, a Florida limited liability company, (“DBC”) and the titled vehicle owner (“Vehicle Owner”) named below. This Agreement will be effective on the date provided in the signature block below (the “Effective Date”).
Vehicle Owner Name *
Address (#, Street, City, State, Zip) *
Phone *
Email *
Vehicle #1 *
Year *
Make *
Model *
Color *
Racing Number, if applicable
If the vehicle is in the US and valued at over $5,000,000, or in Canada and valued over $500,000, please work with DBC’s Coordinator Max Zengage to obtain the proper form. This form will not be valid for vehicles valued at over these thresholds.
Vehicle Insurable Value ($) *
Vehicle Insurance Carrier *
Vehicle Insurance Policy Number *
Vehicle Usage Rights
Vehicle Owner grants DBC use of the Vehicle(s) for the purpose of mobile and stationary promotional and media uses, including, but not limited to, DBC representatives operating, maneuvering or driving the Vehicle(s) during the usage date(s) and at the location, and for the uses stated below. Vehicle Owner will provide DBC a Vehicle Condition Report detailing the condition of the Vehicle(s), located at end of this agreement.

Date: Saturday June 18, 2022
Rain Date:   Sunday   June 19, 2022 (All Participants will be notified if Event Reschedule)
Location: SE 2nd Avenue from SE 1st Street to SE 3rd Street, Downtown Delray Beach, FL 33444

Vehicle Owner(s) is responsible for vehicle transportation.
Vehicle will be used for Display. Vehicle will be used on a closed public road.
Who is maintaining care, custody, and control?
Who is maintaining care, custody, and control? *(Who will be responsible for this vehicle this time? Consider who is holding the keys, who is driving, etc.) *
Name of Other, Approved by Owner
License
1. Vehicle Owner grants DBC the right to: Publish his/her name, automobile club affiliations, details regarding the Vehicle’s history and any other reasonable facts relating to the Vehicle Owner and/or the Vehicle(s) which is supplied by the Vehicle Owner to DBC (the “Information”). Produce photo(s) or video(s) that contain the likeness, image or appearance of the Vehicle(s) (the “Media”).

2. Vehicle Owner agrees that DBC may use and distribute the Information and/or the Media throughout the world in any physical, electronic, or other medium including, but not limited to, editorial content, advertising, promotional or educational materials.

3. Vehicle Owner shall have no right of approval, attribution or claim to compensation in connection with DBC’s use of the Information and/or the Media.
Representatives & Warranties
1. Vehicle Owner represents and warrants that he/she holds the legal title in the Vehicle(s), the Vehicle(s) is/are registered, and the Vehicle(s) is/are insured by Vehicle Owner for all liability and physical damage, covering the full value of the Vehicle(s), while under the Vehicle Owner’s care, custody, and control.

2. Owner represents and warrants that the Vehicle is insured for all uses while the vehicle is under owner's or owner's designated representative's care, custody, and control.
Limitation of Liability and Additional Terms
1. DBC will not be liable to Vehicle Owner for: any negligence or misconduct of the Vehicle Owner or their representatives, or; special or consequential damages, including but not limited to, lost profits, loss of use, and costs of replacement, caused by DBC’s breach of contract, or any other cause whatsoever.

2. DBC’s liability pursuant to this Agreement, or under any theory of law, shall not exceed the total sum payable on behalf of DBC by its insurers in settlement or satisfaction of Vehicle Owner's claims.

3. This Agreement will be construed under and in accordance with the laws of the state of Florida.

4. Any changes to this Agreement must be mutually agreed to by the parties in writing.
Additional Information: Any other info to make known?
SIGNATURE
This Agreement may be signed in counterparts and copies exchanged by email will be binding on the parties.
Vehicle Owner Signature. (By printing your name, you are signing this agreement electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.) *
Effective Date *
MM
/
DD
/
YYYY
COLLECTION MANAGER (Authorized to sign for owner): By printing your name, you are signing this agreement electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.
EXTERIOR CONDITION OF THE VEHICLE *
Good
Damaged
Front Bumper
Rear Bumper
Trunk/Deck Lid
Hood
Roof
Windshield
Paint Condition
Tires/Wheels
Lights Work
Right Quarter Panel
Right Doors/Rocker
Right Fender
Left Fender
Left Quarter Panel
Left Doors/Rocker
Any notes about the EXTERIOR Condition?
INTERIOR CONDITION OF THE VEHICLE *
Working
N/A
Interior Electronics
HVAC/AC System
Any notes about the INTERIOR Condition? (Carpet, seats, seatbelts, dash, windshield, etc.)
Thank you for participating!
Online Registration & Payment Deadline: May 31, 2022.
Payment & event info via www.DelrayConcours.com/car-entry

ONE DAY EVENT - SATURDAY JUNE 18
Set Up/Car Arrival: 8-10 AM – Clean Up/Departure 4-6 PM

Please find the Paypal link to complete the Car Registration Payment - http://www.delrayconcours.com/car-entry - (Include your Name, Car Year & Model in payment)
Sponsorship Promo Code for Approved Reserved Spots (What is Sponsor Company Name?)
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