Owner Information:

Name:                      

Street Address:         

City/State/Zip Code: 

Phone #:            Email Address:  

 JCNA# (if any):         JCNA Club Affiliation (if any):  

Judging:

   I am a JCNA Certified Judge and am willing to assist in judging.     I am not  a JCNA Certified Judge, but am willing to assist in judging.

_______________________________________________________________________

Vehicle Information:

1:  Vehicle 1:

Year/Make/Model/Series/Color:                       

Class:  JCNA Championship JCNA Driven    JCNA Preservation Class

            JCNA Special   Other British Car (Vehicles not being judged by JCNA Concours rules)

 2:  Vehicle 2:                                                      

Year/Make/Model/Series/Color:  

Class:  JCNA Championship JCNA Driven    JCNA Preservation Class

            JCNA Special   Other British Car (Vehicles not being judged by JCNA Concours rules)

  _________________________________________________________________________

Registration Fees:

Early Registration Fee (Prior to March 20, 2008, includes event T-Shirt):           

1st Car: $30.00          Additional Cars:  $25 x =  

                                                                 Subtotal:  

Free T-Shirt Size:  

Registration Fee (After March 20, 2008, does not include event T-Shirt):

1st Car: $35.00          Additional Cars:  $30 x =        

                                                                 Subtotal:  

JCNA & JCCNF Membership for Remainder of 2008:  $45                                                          

(Note that JCNA membership is only required to participate in Official JCNA

competition for national points)

Cocktail Reception Friday Night, April 18, 2007 (cash bar)   # of people: 

Charity Dinner Banquet Saturday Night, Saturday April, 19 2008:  

                   $65 person x =                                                                             Subtotal:  

Additional T-Shirts:

(Qty) Sizes:  $12.00 x    SM    MED    LG     XL                      

                     $15.00 x      XXL        XXXL                                                            Subtotal:  

                                                                                                                       Grand Total:  

  ___________________________________________________________________________________

Payment Options:

  By Paypal : Paypal is widely used, convenient and secure electronic payment system which allows you to charge your credit card or checking account. Clicking on the "Submit" button below (after completing the registration form) will send you to a confirmation screen where you will be able to pay electronically.  Please write down your grand total cost from above, as you will need it at the Paypal site.

                                                                or

  By Check or Money Order:  Print and mail completed form with check or money order made payable to JCCNF / SHRINERS’ CHILDREN’S HOSPITAL to:

                                                      Mrs.Darlene Pair, JCCNF Registrar
                                                     10138 Oakisle Road West
                                                     Jacksonville, Florida 32257-5834       Phone: (904) 268-4045
 

Note:  If you plan to pay by mail, please print the completed form, before hitting the submit button, which will reset the form.

  _________________________________________________________________________________

RELEASE FROM LIABILITY: By submitting this form, I hereby agree to enter the above described Auto(s) in the 2008 Legends on the Green Concours d’Elegance being held at World Golf Village on April 19, 2008. In consideration of the right and privilege to enter and participate and other valuable consideration, and intending to be legally bound, I agree to release World Golf Village, the Jaguar Clubs of North America (JCNA), Jaguar Car Club of North Florida (JCCNF), JCCNF officers and members, and all participating sponsors and supporters from any and all liability for injuries, damage or loss arising from my entry and attendance in the Concours and related activities. I understand that Jaguar vehicles must remain in judging position until 2:30 p.m. JNCA Rules will be adhered to for the Jaguar Concours and I also understand that I must be a member of the JCNA for my car to be judged. Other British marques are eligible for all non-Jaguar specific awards.

                                   Comments:

  Please print completed form for your records before submitting form.

You will receive a confirmation E-mail