FORD COBRA SHELBY REUNION

CELEBRATING 50th ANNIVERSARY OF COBRA

APRIL 19-21, 2012

 

REGISTRATION FORM

 

Registration opens December 1, 2011. Pre-registration ends February 28.

Late registration will add $100.00 to each package (Platinum and Gold)

 

 

NOTE: The Wally Parks NHRA Motorsports Museum is a California nonprofit corporation, tax exempt under section 501(c)3 of the Internal Revenue code. A portion of your payment may be tax deductible as a charitable contribution.

 

PLATINUM PASS – ALL ACCESS -OPEN TRACK PASS: $699.00 Guest: $199.00

The Platinum package is good for access to all events including:

3 days of Open Track on the historic Pomona Road Race Course with instruction.
3 Access to Driver’s Club & VIP hospitality areas.
3 2 cocktail receptions: Thursday meet & greet. Location to be determined. Friday VIP/Media Reception Cobra Exhibit Opening at the NHRA Museum.
3 Banquet honoring Carroll Shelby. Location to be determined.
3 Free entry to the NHRA Museum including 50th Anniversary Cobra Exhibit.
3 Panel discussion at the NHRA Museum, Sat. April 21.
3 Poker Run. Location to be determined.
3 Goody bag.
3 Preferred parking.
3 Luxury bus trip for wives and guests to South Coast Plaza in Newport Beach on Friday, April 20, and to the Richard Nixon Library on Saturday, April 21.
3 Entry to the Fabulous Fords Forever event at Knott’s Berry Farm on Sunday, April 22.

 

 

GOLD PASS -ALL ACCESS: $449.00 Guest: $199.00

 

The Gold package is good for access to the following events: Does NOT include Open Track participation.

3 Access to Driver’s Club & VIP hospitality areas.
3 2 cocktail receptions: Thursday meet & greet. Location to be determined.
Friday VIP/Media Reception Exhibit Opening at the NHRA Museum.
3 Banquet honoring Carroll Shelby. Location to be determined.
3 Free entry to the NHRA Museum including 50th Anniversary Cobra Exhibit.
3 Panel discussion at the NHRA Museum, Sat. April 21.
3 Poker Run. Location to be determined.
3 Goody bag.
3 Preferred parking.

 

SILVER PASS – Show ’N Shine Entry only: $75.00 Guest: $50.00

3 day entry with your Show ’N Shine vehicle.
3 Free entry to the NHRA Museum including 50th Anniversary Cobra Exhibit.
3 Panel discussion at the NHRA Museum, Sat. April 21.
3 Goody bag.

 

CARROLL SHELBY TRIBUTE BANQUET ONLY: $150.00 per person/$1,100.00 per table (8) Saturday, April 21. Location to be determined.

 

 

REGISTRATION FORM

 

 

Name:____________________________________________________________________

 

Address:___________________________________________________________________

 

City:______________________________________Zip:____________________________

 

Phone #:_________________________Email:__________________________

 

AAA member#:__________________

 

Car type:______________________________________Year:________________________

 

Circle preferred run group if participating in Open Track: Advanced Intermediate Novice

 

PACKAGE:

 

Platinum Pass – All Access Open Track Pass: #_______@ $699.00 $_______________

 

Platinum guest (Must be purchased with Platinum package): #_____@ $199.00 $___________

 

Gold Pass – All Access NO Open Track: #_______@ $449.00 $_______________

 

Gold guest (Must be purchased with Gold package): #_______@ $199.00 $_______________

 

Silver Pass -Show ’N Shine Entry only: #_______@ $75.00 $_______________

 

Silver guest (Must be purchased with Silver package): #_______@ $50.00 $_______________

 

Tribute dinner only: #_______@ $150.00 $_______________

 

Table of 8: #_______@ $1,100.00 $_______________

 

TOTAL: $_______________

 

 

 

PAYMENT INFORMATION:

 

Check (payable to NHRA Motorsports Museum)

 

VISA MasterCard Discover (circle one)

 

Credit card number:_________________________________________________________

 

3-digit code:______________________ Exp. date:___________________________

 

Name as it appears on card:_____________________________________________________

 

Billing address:______________________________________________________________

 

City:_____________________________________________Zip:________________________

 

Signature:____________________________________________

 

Remit payment to:

 

Wally Parks NHRA Motorsports Museum

Ford-Cobra-Shelby Reunion

1101 W. McKinley Ave., Bldg. 3A

Pomona, CA 91768

 

Tel.: 909.622.8562 Fax: 909.622.1206