Member #__________

DOWN EAST RODS & CLASSICS CAR CLUB
Membership Application

Name___________________________________________________________

Address_________________________________________________________

Phone(Home)______________________(Work)_________________________

E-mail__________________________________________________________

T-Shirt Size______________________________________________________

VEHICLE DESCRIPTION: Car or Truck (Circle One)

Year___________________________Make____________________________

Model__________________________________________________________

Stock, Street, Strip, Other (Circle all that apply)

MEMBERSHIP DUES:

$50 per member for first year ------ $25 every year after

If more than one member per family, additional member(s)
pay $30 first year and $15 every year after.

WAIVER

By my signature below I acknowledge that I have read and will comply with the By-laws of

Down East Rods & Classics (the “Club”).I hereby agree to release the Club from any and al

l liability arising out of my participation in the club, including physical injury,death, and/or property

damage. I further agree to indemnify and hold harmless the club from and against any and

all third party claims,actions, liabilities, and /or damages arising out of my participation in the club.

Signature_____________________________________________Date_________________