Please check ONE category: 

KKOA Member - $20 _______    or   Non-Member - $30 ______

Show Special:

Join KKOA for one year, receive a subscription to the TRENDSETTER Magazine and enter the contest - $40 ______

(Note:  Paid model entry also entitles the entrant only to a 3-day gate pass to the 2008 KKOA Leadsled Spectacular)

 

If you are a current member of the KKOA, please print your membership number here ______________________

 

Name ______________________________________ Street Address _________________________________________

City _________________________________  State _______ ZIP ___________ Phone ____________________________

Email address ____________________________________________________

Model Car Club Affiliation: ____________________________________________________________________________

How many models are you entering?____________________ (If possible, please enclose list)

Will you be setting up a display with model? Yes ____  No ____, approx. size ______x______  (no electrical hookups available)

Payment (check one): Check _______ Money Order _______ VISA _______ MASTERCARD _______

VISA/MASTERCARD No. ___________________________________________Expires ________/___________

Signature (All entries must be signed) __________________________________________________________________

 

Please complete and send to event director:  Elden Titus c/o KKOA, 26 Main, Cassville, Missouri  65625

 

In consideration of the acceptance of the right to participate , entrants, participants, and spectators, by execution of this entry form, release and discharge Kustom Kemps of America, KC Slammers, City of Salina, State of Kansas and their officials, directors, employees, agents, representatives, and servants, and anyone else connected with management or presentation of the Model Kemp Spectacular 2008 of and from any and all known damages, injuries, losses, judgments, and/or claims from any cause whatsoever that may be suffered by any entrant to his person or property.  Further, each entrant expressly agrees to indemnify all of the foregoing entities, firms, persons, and bodies, of and from any and all liability occasioned or resulting from the conduct of entrants or any participant assisting or cooperating with entrant and under the direction or control of entrant.  Entrants agree that participation in any contest, game, or activity may be limited to vehicles that the management believes safe to participate.  No Refunds Please.

Please print this page, fill out the form, and send it along with payment to event director:  Elden Titus,  c/o KKOA, 26 Main, Cassville, Missouri  65625

You may also simply bring it the day of the contest or we will have extras to fill out at the event site.

If the form won’t print cleanly on your printer in portrait mode, try Landscape format!