Pre-Registration Form

Please complete this form and bring it with you if you don't pre-register.  This form must be signed and submitted the day of the show. 
Participants assume all risk and liability for their actions and vehicles.  By signing this form, I hereby release The Barnesville Pumpkin Festival and
Scott Ferguson from any and all liability, present and future.  To pre-register complete form and mail to:

Scott Ferguson
328 High St.
Barnesville, OH  43713

Info:740 425-2503
Make Checks Payable to: Barnesville Pumpkin Festival

NAME:                                                                                                         Date:____________________________

SIGNATURE:________________________________________________

ADDRESS:_________________________________________________________

CITY:_______________________________________________________________

STATE: ___                                ZIP:_______________

MAKE: _                                                  MODEL:                                                        YEAR:_____________________
 

PRE-REGISTER $8.00-- DAY OF SHOW $10.00
WE URGE YOU TO PRE-REGISTER