DOWNLOAD FORM HERE
_______________________
Car Number
(WCC internal use only)
914 West Coast Classic 2006 July 7-9, 2006 Portland, Oregon Event Registration Form
Please fill out a separate registration form for each adult in your party that will have a 914 or other auto participating in our event. Each car participating needs to have a driver registered as the Principal Registrant. A single co-registrant may participate at no additional charge. Additional friends and family can participate with an additional fee as described below.
Principal Registrant and 1 Co- Registrant $150.00
Name: ________________________________________
Address: ________________________________________
City, State, Zip: ________________________________________
Home Phone: ________________________________________
Cell Phone ________________________________________
Email ________________________________________
914World.com
Screen Name ________________________________________
Co-registrant ________________________________________
May participate in all events but will not receive “goodie bag”
Family and Friend Registrants
Will additional family members or friends be attending the WCC events with you? By paying the supplemental registration fee, these guests may participate in group meals, road tour and the Historic Races at PIR. These guests will not receive goodie bags.
Names of Supplemental registrants________________________________________________
#______ @ $35.00 each
Total Registration Fees $___________
About the Car you’ll have at the 914 West Coast Classic 2006:
______ Check if you will drive a car during the event, but not a 914.
914: Year: ______ Check one: 914/4______ 914/6_______ 914/8_______
Exterior color:________________________ (simple color names…not paint codes please)
License plate:________________________
Special feature(s) of your car? (i.e. V8, Suby, Trailered race car, Limited Edition, anything we might want to know.
____________________________________________________________________________
Other 914 WCC 2006 events / items to be paid directly to others sponsoring these events:
Charity Autocross at PIR on 7/9, $5.00 per run payable at the event : Class your car below:
Stock= stock, no carbs, no wide wheels, R tires OK Prepared=anything else, engine size only
S1 1.7/1.8____ S2 2.0____ (includes stock factory 6)
P1 Under 2.0____ P2 2.0 to 2.4____ P3 2.5 to 3.0____ P4 3.2 and up___
_
Box lunch(s) orders for the Road Tour Quantity
What type of lunch do you want: Meat/cheese _______Vegetarian_______
So we can better plan and coordinate, …answer Yes or No please:
Circle yes / no as applies
Y N Will you drive a 914 in the Road Tour on Saturday, July 8?
Y N Will you drive a car other than a 914 in the tour?
Additional comments …special requests? How can we help meet any special needs?
Hotel Accommodations: Participants are responsible for making their own hotel reservations. The WCC 2006 Headquarters Hotel is the Monarch Hotel located in Clackamas, OR. The toll free phone number is 800-492-8700. Be sure to tell them that you are with the sports car group’s block of rooms for July 6-8, 2006.
Release of Liability
We the undersigned, for and in consideration of West Coast Classic 2006 permitting the below named persons to enter/operate as participants of the herein named event, HEREBY RELEASE West Coast Classic 2006, its officers, directors, agents and members, and their heirs, personal representatives, assigns and agents from any and all liability, actions, causes of actions, demands or suits whatever, which we may at any time hereafter have or claim to have, on account of or arising out of, any personal injuries or damages to the participants and their motor vehicles, including but not by way of limitations, the right to be paid for any loss of time, loss of services, or for expenses to an accident or injury which the below named participants might suffer at any time hereafter while participating as a driver/passenger of a motor vehicle or participating in any other activity during this event.
We, the undersigned, acknowledge reading and understanding this release and acknowledge the inherent danger of participating in an event of this type.
Registrant Signature: ___________________________________Date: ______________
Print Name: _____________________________
Co-Registrant Signature: ________________________________Date: ______________
Print Name: _____________________________
Signature(s) of Additional Participants: _______________________________Date: _________
Printed Name(s): ______________________________________________________
Include signature of parent or guardian if any of the above participants are minors.
Submitting your Registration Form
Please download these 3 pages, complete, sign and mail with your check, payable to:
WCC/Camp 914
Send to:
WCC ‘06
1580 Bedford Court
Lake Oswego, OR 97034
Please send this completed and signed registration form and full payment so that we receive it not later than May 31, 2006. There will be no refunds of registration fees after May 31 because of commitments made to others on your behalf. Please don’t wait until the last minute so we may better plan a good time for all.
Additional details regarding the event will be sent to registrants after receipt of your completed forms and payment.
If you have questions about registering you may email jimchambers41@hotmail.com for answers.