Dingman Township Presents

Car & Motorcycle Show in the Park

Sunday, May 19, 2019

DingmanTownship Rereational Park

679 Log Tavern Road, Milford, PA

Registration Form


CAR SHOW REGISTRATION FORM ENTRY# _______________* Township assigns


OWNER/PARTICIPANT NAME: ____________________________________________


ADDRESS: ____________________________________________________________




PHONE:_____________________          E-MAIL_______________________________


YEAR:______________________MAKE:_______________ MODEL:______________


COLOR:____________ MODIFIED: YES___________ NO_______________


CLUB AFFILIATION: YES__________ NO___________


NAME OF CLUB:________________________________________________________


HOW DID YOU HEAR ABOUT TODAY’S SHOW? _____________________________


HOW MANY MILES DID YOU DRIVE HERE TODAY? __________________________


In consideration of the acceptance of my participation in the Car & Motorcycle Show in the Park on Sunday, May 19, I, the undersigned, intend to be legally bound, I for myself, my family members, employees, agents heirs and assigns, executors, and administrators, hereby waive and release any and all claims which I or they might have against Dingman Township, Dingman Township Board of Supervisors, Dingman Township Parks and Recreation Commission, their officers, employees, volunteers and participants as a result of my participation in the above program.  I further agree to indemnify Dingman Township, its officers, employees and volunteers against claims made against it or them as a result of my participation in the above program.


Signature: __________________________________   Date:___________


Please return form to: Dingman Township,118 Fisher Lane, Milford, PA  18337

You may mail it, drop it off, fax it to 570-296-2150 or e-mail it to: recbd@ptd.net

Form must be returned by May 13, 2019.


Drive-Ins will be welcome the day of the Show.


$10.00 entry fee Check # _________  Cash _________


Proceeds of the event will be donated to:

Pike County Humane Society

(donations of food, supplies for the Food Pantry and PCHS will be accepted)