MAIN STREET MARKHAM!

Registration Form
Registration on the day of the event is $20

Please provide the following information:
Name:

_______________________________________________________________________________________
Street Address:

______________________________________________________________________________________
Address continued:

_______________________________________________________________________________________

City:

____________________________

Province:

____________________________

Postal Code:

____________________________

E-Mail:

_______________________________________________

Telephone

____________________________

Please list the make, model and year of the vehicle you intend to bring. (If you intend to bring more than one car, please fill out a separate form for each car.)

Make	______________________________________________________
Model	______________________________________________________
Year	________________
Car Club affiliation, if any:
_______________________________________________________________________
Other Comments:
________________________________________________________________________
For Office Use Only: Registration #_________________________