Young Backyard Builders Program Application Name * First Name Last Name Phone * (###) ### #### Email Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Year * Make * Model * Color * Has body been changed or modified? * Yes No Interior * Original Custom Engine * Stock Altered Display size * 10'x10' (i.e. motorcycle display) 10'x20' (standard vehicle) I require electrical * Yes No I am aged 18-27 * Yes No Shirt size * S M L XL 2XL 3XL 4XL Terms and Conditions * The exhibitor hereby applies to the Producer of the custom auto show as referred to above to have the vehicle above described displayed at the show under the following terms and conditions: 1. Producer has final authority to determine the locations of display. 2. Once the display is set up it shall not be removed or concealed until the close of the show 3. No promotion and/or advertising allowed with entries unless they are appearing in conjunction with paid commercial space. A sign to identify the modifications, who did them and what equipment was used is okay. Large handbills, signs, and business card distribution is prohibited. 4. In consideration of this entry, the Exhibitor and those persons within the Exhibitor’s direction or control agree to permit the Producer or its assigns the use of name and pictures for publicity, advertising, and commercial purposes including newspapers, magazines, radio, internet, and television, before, during, and after the event. All publicity and advertising rights are reserved by the Producer, or its assigns. 5. Neither the Producer, Show Chairman, Sponsor, any other director officer or the owner of the building at which the show is produced shall be responsible or liable for any personal injury to Exhibitor or any person affiliated with the Exhibitor, including but not limited to any person or minor under direction or control. Exhibitor assumes all risk and shall be solely responsible for any damage to all or any part of the Exhibitor’s personal property, including, but not limited to, vehicles, trailers, displays, material, and/or parts. Exhibitor expressly waives all rights for any loss or damage against them. Exhibitor agrees to obtain insurance covering the above and assumes responsibility for loss or damage. Exhibitor agrees that this signed entry blank supersedes any and all agreements and understandings, oral or written. Both parties agree all disagreements will be decided by arbitration in the state where the show is produced. I have read and agree to the terms and conditions Signature * By checking the box above and providing my name in the signature field below I am consenting to the terms and conditions above. If exhibitor is under the age of 18, parent or guardian must provide consent. Date * MM DD YYYY Photo Acknowledgement * Email or text a photo of the vehicle/s within 7 days of application to: Mike Busche 218-349-8413 mbusche@motorheadmadnessmn.com Photo must be received within 7 days of application or application will be canceled. If you need help with registration contact Dean Birman at 218-591-8640 after 5:00pm or on weekends. I understand I must submit photo via text or email within 7 days or my application will be canceled. Payment- Credit Card Name After clicking submit, you will be redirected to a page for credit card payment. If the name on the credit card you will use is different than the name on this vehicle application, please enter the name on the credit card here. ONLY CLICK THE SUBMIT BUTTON ONCE. It may take a second to redirect. Thank you for submitting your vehicle application for the waiting list. If a spot opens up, we will contact you.
