June 11 & 12, 2005

For vehicles dating from 1901-2005

Registration must be received no later than
4:30pm, May 20, 2005


2005 Registration Form
(One form per vehicle)

Participant Guidelines (please read carefully):
Only those who have completed this registration form will be permitted to display vehicles along History Road.
You must complete one registration form for each vehicle you wish to display.
The information from this registration form will appear in a laminated sheet displayed in the window of your vehicle to inform the public about your vehicle.
There is no registration fee for this event.
Pre-registered vehicle driver/owner will receive free admission to the Museum and the grounds on the day(s) their vehicle(s) is on display.
One passenger per vehicle will receive complementary admission courtesy of the Alberta Motor Association and the City of Wetaskiwin.
All vehicles registered for display must be on site by 9:00am for marshalling.
Owners must commit to having their vehicle(s) on display from 11:00am to 4:00pm.
Owners are responsible for security, protection and insurance of their vehicles while on display.
Vehicles may not be displayed for promotional or sale purposes.  Signage reflection either of these purposes is not permitted.
 
Registered participants will recieve:
History Road 2005 dash plaque. Free admission to Reynolds-Alberta Museum.
Laminated vehicle information display sheet. Participant Ribbon.
Color photograph of your vehicle. Opportunity to win valuable prizes.

Name or Contact:
Mailing Address:
City/Town:
Province:
Postal Code:
Email Address:
Home Phone :
Business Phone:
Fax Number:

I will display my vehicle on:
Saturday, June 11, 2005 Sunday, June 12, 2005 Both Days
I will display my vehicle in:
Chronological Display Motorcycle Display Hot Rod and Custom Display
I will participate in swap meet:
Yes No

Vehicle Specifications

Year:
Make (eg. Honda, BMW, Norton):
Model (eg. CB750, R1200, Commando):
Type (eg. Cafe-Racer, Dirt, Chopper, Street):
Displacement (cu. in. or c.c.):
Engine (eg. Four-stroke twin, Single, Knucklehead):
Original Cost (US or Cdn): $

Unique features and / or facts about this specific vehicle (point form please):

Collection of the personal information on this form is authorized under Section 6 of the Alberta Historical Resources Act and is required for the purpose of staging the Reynolds-Alberta Museum History Road Special Event.  The information will be used to maintain a contact list of participants and is subject to the disclosure rules set forth in the Freedom of Information and Protection of Privacy Act.  For further information about the collection and use of this personal information, please contact Debi Bailer, Group Marketing Coordinator; (780) 361-1351, Ext. 251