Please Fill Out Form Below, Print It and Send it Via Snail-mail / Fax

Or bring it to our show and take it directly to the Raffle Booth

It's Free To Participate in the Tattoo Contest Please Read Carefully

      Tattoo Contest Entry Form

I wish to participate in the Following Contest

Vitals

1 Your Name.....
2 Club Affiliation.
3 Address........ 
4 City............ 
5 State..........  
6 Postal Zip.....  
7 Telephone...... 

 

Liability Release: By execution of this form, I do hereby release and discharge the City of Canoga Park CA, Ed Roth Estate, Moldy Marvin, Elks Lodge # 2190, Galpin Ford, Automated Entertainment, Kulture Shoq, The Mutilators Motor Club, and any members or employees thereof for any injuries to myself and all damages that may occur to my vehicle or vehicles while I am participating in Moldy Marvin's 5th annual Rat Fink.Party / Kustom Kulture Extravaganza, Klassic and Kustoms Show Saturday July 12th, 2002.

Signature _________________________ Date ___________ 

Send it To Us or Fax it to: (661) 944-2348

Or bring it to our show and take it directly to the Raffle Booth

@utomated Entertainment P.O. Box 1079 Little Rock, Ca 93543

(800) 880-6567 or (661) 944-2299

Copyright 2000/2001/2002/2003 @utomated Entertainment Little Rock, CA