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Cruisin' For Salem Firefighters - Car Registration
Use this form to register up to 3 cars.
Contact Information (Owner)
Name
*
First Name
Last Name
Email Type
*
select one
Home
Work
Other
Email
*
Verify Email
*
Phone Type
*
select one
Home
Work
Mobile
Other
Phone
*
Address Type
*
select one
Home
Work
Other
School
Business Name
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Car Information
How many cars do you plan to register?
*
Register up to 3 cars online. Registration fee for each car is $25.00 (please contact us directly if you need to register more)
select one
1 Car
2 Cars
3 Cars
Car Information - Car 1
*
Please include your car's year, make, model, class and car club affiliation.
Car Information - Car 2
*
Please include your car's year, make, model, class and car club affiliation.
Car Information - Car 3
*
Please include your car's year, make, model, class and car club affiliation.
Car Registration Fee
*
$25
-
Car Registration Fee - 1 Car
$50
-
Car Registration Fee - 2 Cars
$75
-
Car Registration Fee - 3 Cars
Would you like to purchase raffle tickets?
*
Raffle will be held at the end of the event. Need not be present to win.
select one
Yes
No
Raffle Tickets
*
Quantity
$5
-
1 Ticket
0
1
2
3
4
5
6
7
8
9
10
10
$20
-
5 Tickets
0
1
2
3
4
5
6
7
8
9
10
10
Would you like to a donate to the Salem Fire Foundation?
*
Donations are tax deductible
select one
Yes
No
Donation to Salem Fire Foundation
*
$1,000
$500
$250
$100
$75
$50
$25
$
Acknowledgements
*
1) I agree to release the Salem Fire Foundation and its event affiliates from any responsibility and liability for any damages, losses and injuries related to my participation (or my party's participation) in this event. 2) I understand that cars will be assigned to a space first come first serve and that the event hosts will not provide anything except the display space. 3) I understand that registrations are non-transferable. 4) I agree to display my car in my assigned space until the end of the event (3 pm). 5) I agree to not allow attendees to sit in or touch my car. 6)I understand that awards are given at the discretion of the event hosts. 7)I understand that photos will be taken during the event and that pictures of me and my car may be posted online or used in print media. 8) I understand that registration fee, raffle ticket purchases and donations are NOT refundable. 9) I understand that this is a family-friendly event. No alcohol, firearms or foul, abusive or disruptive language and/or behavior is allowed. 10) I understand that drag racing, burnouts, revving engines, reckless driving in or anywhere near the event site are strictly prohibited. 11) I understand that selling items is restricted to registered event vendors only. 12) I agree to not play music through external speakers (event hosts will provide music at the show)
I agree
Inform me of future Salem Fire Foundation events
Yes
Add 3% to my total amount to help cover the payment processing fees
