MOUNTAINS MUSIC
AND MODEL A's
2014 MEET


September 29 - October 2, 2014


Host: Smoky Mountain Model A Club
P.O. Box 70373
Knoxville, TN 37938

Last Name ____________________________ First Name___________________________

Spouse/Guest(s)_____________________________________________________________

Address ___________________________________________________________________

City, State, Zip ______________________________________________________________

Phone (for questions) _________________________________________________________

Club Name and City __________________________________________________________

Registration (per couple) before Sept 5,2014

$80.00*

how many attending _________________
Registration postmarked after Sept 5,2014

$90.00*

how many attending _________________
Swap Meet Space - per day/per space

$20.00

days _____________________________
Banquet per person

$40.00 **

# attending ________________________

GRAND TOTAL SUBMITTED _$_______________________ CHECK # ____________

Mail Check and Application To:

Smoky Mountain Model A Club
P.O. Box 70373
Knoxville, TN 37938

To participate in any scheduled event, you must be registered. Please be aware that some events are limited to a certain number of participants and may not be available at a later date. We encourage everyone to make reservations as soon as possible, while plans are flexible and while an increase in the planned number of participants may yet be possible. I hereby release The Smoky Mountain Model A Club, and all participating members and individuals from any and all liabilities. No registration will be granted without the submittal of a signed registration form, which shall constitute acceptance of this release, signed on behalf of all family or guest participants, A cancellation fee of $25.00 will be charged after Sept 5,2014. This fee does not apply to vendors.

signed name____________________________ printed name_________________________________

* Includes welcome party, tours and seminars.
** Includes dinner and entertainment, and door prizes.