Your InformationName(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Vehicle InformationVehicle Year(Required)Make(Required)Model(Required)Color(Required)Any Other Vehicle Information:Consent(Required) I agreeTHE UNDERSIGNED HERBY ACCEPTS AND ASSUMES ANY AND ALL RISKS, CLAIMS, ACTIONS AND DAMAGES, DIRECT OR INDIRECT WHICH THE UNDERSIGNED MAY OCCUR AS A RESULT OF PARTICIPATION IN AN EVENT OR ACTIVITY WHICH IS SANCTIONED BY SMSA. I EXPRESSLY AGREE THAT I WILL HOLD THE SMSA, THE CITY OF SUMNER, AND ALL OF THEIR RESPECTIVE EMPLOYEES AND OFFICERS, EMPLOYEE AGENTS, REPRESENTATIES, SUCESSORS OR ASSIGNS HARMLESS AND OTHERWISE INDEMNIFY THE SAME AGREEMENT BE BINDING UPON, MY AGENTS, REPRESNTATIVES, HEIRS AND ASSIGNS.Signature(Required)Reset signature Signature locked. Reset to sign again Date(Required) MM slash DD slash YYYY Product Name(Required)Registration Fee - Classy Chassis 2022Credit CardCard Details Cardholder NameTotal If you have any questions, please contact the Sumner Main Street Association at 253-891-4260 or events@sumnermainstreet.com
