BLUES CRUISE REGISTRATION FORM

Name: ________________________________ Phone: ___________________

Address: ______________________ City, State: ________________ Zip: _______

Year: ___________ Make: ________________ Madel: _____________________

Class: (circle one)

Street Rod/Hot Rod       Custom       Classic       Muscle Car

Sports Car (Corvette, Porsche, Viper, etc.)

Registration Fee: $15 per entry plus a toy     Total Enclosed: __________

The signature on this form indicates that: Merlinos' Belvedere Restaurant or any parties
sponsoring this event are NOT responsible for any losses, damages or injuries that might
occur during the Blues Cruise. I also agree that my name and photos of my vehicle may be
used for publicity or advertising. Each participant must have proof of insurance.

Signature: ____________________________ Date: _____________

Please Make Checks payable to: Belvedere Blues Foundation, 1330 Elm Ave., Canon City, CO 81212
The event takes place on Sunday, September 10, 2006 . 10am Registration, 11am Ride Leaves to the Royal Gorge Bridge
2pm - Car Show back at the tent