erkeley Lake Car Show Saturday, June 5, 2010 Benefiting the Lake Berkeley Chapel 4043 South Berkeley Lake Road Duluth, GA 30096 FREE SPECTATOR ADMISSION Food and Beverages available Fun for the Whole Family! LIVE MUSIC, GAMES, FUN FOR ALL Show 10:00 am - 3:00 pm Lunch Served 12:00 pm - 2:00 pm Rain or Shine ?Open Show? ? Awards for: *** Men?s Choice *** / *** Lady?s Choice *** / *** Kid?s Choice *** All Pre-1980 Vehicles Welcome ?.. Awards announced & presented at 2:00 pm For More Information Contact Randy Johnson: 770.729.8786 / (randy@therandalgroup.com) ?Tax Deductible? ------------------------------------------------------------------------------------------------------------ Return Completed Form, Sign & Provide Check Payable To: Lake Berkeley Chapel Berkeley Lake Car Show Attn: Randy Johnson 296 Lakeshore Drive Berkeley Lake, GA. 30096 Vehicle Registration: $25.00 Each additional Vehicle: $10.00 Please duplicate this form for each additional vehicle to provide a record of entries. Name: ______________________________________ Phone: _____________________ Address: ______________________________________________ E-mail: ________________________________________________ City: _______________________________________ State: __________ Zip: __________ Make: ______________________________________ Model: ___________________________________________ Year: ____________ Waiver of Liability: I Release and discharge, Lake Berkeley Chapel, City of Berkeley Lake, Berkeley Lake Homeowners Association, show volunteers, and anyone else connected with this event, of any and all liability and damages from any cause whatsoever, inclusive. Signature: ________________________________________________