Name(Required) First Last Phone(Required)Email(Required) Vehicle InformationCar Entry Price: Year(Required) Make(Required) Model(Required) Color(Required) Car Club Affiliation Liability Release(Required) I agree to the Liability Release.Entrants and Participants by execution of this form, release and hold harmless VAREP, The Vine Church, any of the sponsors, food vendors, vendors, their officers, directors, employees, agents and representatives and anyone connected with the presentation of this event from any known and unknown damages, injuries, losses, judgements or claims from any causes which may be suffered by any of the entrants or participants to this person or property.Total Credit CardCard Details Cardholder Name