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Long Island Cruizin’ For A Cure

A recognized 501C3 charity. Donations are tax deductible. Consult your tax advisor for specifics.

EXHIBITOR REGISTRATION

www.licruizinforacure.com • info@licruizinforacure.com • 888-LICRUIZ (542-7849)

1400 Old Country Road, Westbury – just west of Wantagh Parkway

Wantagh Parkway Old Country Road West Exit

PSA Testing For Early Detection of Prostate Cancer Provided by

Sunday September 10, 2017 – No Rain Date

Car Exhibitor gate opens at 6:30 am – show hours (visitors) 9:00 am to 3:00 pm Proceeds go to Prostate Cancer testing, Research And Education on Long Island

This show is all about having fun and saving men’s lives!

Car Exhibitor Registration Form 2017

$25.00 Registration Must Be Received before September 01, 2017

Name *

Address *

City *

State *

ZIP Code *

Phone Number *

E-mail Address *

Are you a survivor? *

Your Registration fee includes a t-shirt - please indicate your size here

Buy extra T-Shirt ($10.00 ea.) *
Quantity
Size

Additional Donation Amount (Suggested Donation - $25.00)

The "CHECKOUT NOW" button will take you to our payment processing page.

PLEASE WAIT TO BE REDIRECTED BACK TO OUR SITE AFTER SUBMITTING YOUR TRANSACTION.

 

www.licruizinforacure.com • info@licruizinforacure.com • 888-LICRUIZ (542-7849)

PLEASE CONTACT SANDY KANE, 888-542-7849 FOR MORE INFORMATION

LIABILITY RELEASE AND INDEMNITY AGREEMENT I hereby release and forever hold harmless Long Island Cruizin’ For A Cure, it’s officers and all volunteers associated with the event, Valley East Building Maintenance and subsidiary companies, and the other participants in the Event from all injuries, liabilities, or expenses of any kind that are caused by the action, negligence, failure to act or condition of the property, facilities or equipment of any Released Party and that arise in connection with the Event or my or attendance thereat. Any provisions herein found by a court to be void or unenforceable shall not affect the validity or enforceability of any other provision. By submitting payment you agree to the terms.

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