1995 Vintage Triumph Register National Convention Registration Form
Registrant Information
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Driver A (as you'd like it to appear on your name_badge)
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Name B (as you'd like it to appear on your name badge)
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Address
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City, State, Zip
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Home Phone
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Additional non-driving family members (for name tags)
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Vintage Triumph Register membership #
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Local Triumph Club Affiliation
__________________________________________________________ S M P
Vehicle Year / Model / Comm. # , Stock, Modified or Prepared
Please indicate which events you will be participating in:
(Note: maximum 2 drivers/car/driving event)
Wed. * ___ Funkhana with ___ driver(s)
___ Pool Party with ___ people
Thurs. * ___ Autocross with ___ drivers(s)
___ Hotel Rallye
Fri. * ___ TSD Rallye
* ___ Fun Rallye
Saturday ___ Concours
___ Participants' Choice
Participation in at least one Moving Event is required to
enter the Concours and Participants' Choice car shows.
Qualifying Moving Events are denoted by an asterisk (*).
Cancellations before July 1, 1995 will be subject to a $15
cancellation fee. No refunds will be made on or after July 1,
1995. If you need more information, call (815) 332-3119 before
10pm Central Time.
Waiver
Proof of car insurance is required to participate in moving
events. Under VTR rules, all Triumphs entering Concours and
Participants' Choice car shows are required to participate in at
least one moving event. Tech and safety inspections are
required in order to participate in the Autocross. Any vehicle
may be disqualified at the Technical Inspector's discretion for
safety reasons. I am aware of the hazards inherent with motor
vehicle events and specifically release and do indemnify the
organizers, support- ing sponsors, the Illinois Sports Owners
Association, and the Vintage Triumph Register, collectively and
separately, from any and all liability from personal injury or
property damage incurred by me or my guests while participating
in this convention. I understand that the Illinois Sports
Owners Association reserves the right to revoke my registration
and retain my registration fee should I engage in reckless,
dangerous and/or unsafe behavior. I have read, understand, and
agree to this release.
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Signature (Driver A) Date
We must have your signature to process your registration.
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Convention Fees
Base Registration
VTR Member 1 car, 1 driver $70.00 ________
Non-VTR Member* 1 car, 1 driver $95.00 ________
* includes 1 year VTR Membership
If postmarked before May 15 deduct: -$10.00 ________
Additional Driver $15.00 ________
Additional Non-Drivers $5.00 x ___ = ________
Additional cars,same driver(s) $25.00 x ___ = ________
Attach separate form(s) with
registrant & vehicle info only
Optional Events
Midwest Cookout $15.00 x ___ = ________
*Breakfast Tour $7.00 x ___ = ________
Awards Banquet Adult $25.00 x ___ = ________
Child (12 & under) $13.00 x ___ = ________
Regalia (no orders taken after 7/1/95)
Convention T-Shirt
____+____+____+____+____ = ______ x $12.00 = ________
S M L XL XXL
Convention Sweatshirt
____+____+____+____+____ = ______ x $25.00 = ________
S M L XL XXL
Convention Hat ______ x $10.00 = ________
XXL sizes add $2.00 per shirt ______ x $2.00 = ________
GrandTotal ______________
Please make checks or money orders(in U.S. Funds)
payable to ISOA and mail with this registrationform to:
1995 VTR Convention, c/o Ann or Tim Buja
1173 Butler Road
Rockford, IL 61108-4702
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