FALL DIE CAST & TOY SALE

October 16, 2010

REGISTRATION FORM

Exhibitor’s Name_____________________________ Phone (_____)_________

Address__________________________________________________________

City___________________________________ State_________ Zip_________

e-mail___________________________________________________________

Number of tables @ $10.00 each ____________

Make check payable to: “Local 974 UAW”

Mail Registration Form and check to:

UAW Local 974, 3025 Springfield Rd, East Peoria IL 61611

Registration Deadline: October 8, 2010

( ) Check here if you would be willing to donate an item for use in a door prize

drawing during the show.

Exhibitor is responsible for collecting and paying all appropriate sales taxes.

Tables are reserved in order of payment.

RELEASE

I hereby release the UAW or any persons involved with this show from any claims for damage, loss or injury. I understand that insurance for these problems is my responsibility. I agree to abide by rules and regulations needed to make this event a success.

Exhibitor’s Signature ___________________________________________________

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