Please provide the following contact information:

Name
Street address
Address (cont.)
City
State
Zip/Postal code
Email
Cell Phone
Work Phone
Home Phone
Car Make
Model
Year
Color
How did you hear about our show?
Please read agreement:	I agree to hereby hold harmless FACES: The National Craniofacial Association and its organizers, sponsors, and participants of the Ride 4 Smiles from any claims, damage, injury or loss regarding the event. I agree to abide by all guidelines and rules set by the organization, judges and governing bodies. By checking the box below, I hereby agree to take full responsibility for myself, my car and my actions and I do not hold the Ride 4 Smiles Car Show and its organizers/sponsors responsible for anything. I understand all rules and claim by my submission that all the above information is correct and understand that any false information can jeopardize my eligibility in this competition. In addition, I understand that as space is limited at the FACES Ride 4 Smiles Car Show, my pre-registration payment is non-refundable and I will not charge back this order. Vehicle owner's personal insurance will cover vehicle and personal property before, during and after the event. Please check one: I agree to the above.     I do not agree to the above.

Select any of the following options that apply:

Please reserve a spot for me.  I will send a check to
      FACES; P O Box 11082; Chattanooga, TN 37401.

Please reserve a spot for me.  I am paying online by credit card.