Show Car Registration    

Submit this on-line entry registration or download a mail in registration form.

Car Owner's First Name:  

Car Owner's Last Name:  

Mailing Address:  

City:  

State:  

Zip Code:  

Email Address:  

Select Vehicle Year:  

Vehicle Make:  

Vehicle Model:  

Vehicle Body Style:   Stock     Street Rod     Custom

Additional vehicle details we may need to know:  

Release and Regulation Agreement:  

I Agree   I Disagree


Pay Fee By:   On-Line PayPal     Postal Mail


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  You will be transferred to a secure PayPal page.


Mail In:
Newport Lions Club
Show Car Registration
P.O. Box 398
Newport, Indiana 47966-0398





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