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MID-CITY CAR SHOW REGISTRATION FORM
Registration Fee - $25

NAME:
ADDRESS:
PHONE:
CAR MAKE:
YEAR/MODEL:
Make checks payable to:
MAIL TO:                              MID-CITY SHRINE CLUB      PO BOX 247        LYMAN, SC  29365  

Neither Mid-City Shrine Club, it's Officers nor Members shall be responsible for any damages
 or injuries due to accident or otherwise.