10th Annual Mackinac Bridge Crossing

1. Fill out this form and the participant form COMPLETELY. st st st st 2. Enclose the correct funds - Drivers Jan. 1 – Aug. 1 $55.00, Aug. 1 – Sept. 1 $65.00, No Driver Entries After September 1 st ! Buddy Riders (Age 16+ ONLY) Jan. 1st – July 15th $40.00, No Buddy Rider Entries After July 15 th ! 3. Enclose $15 (per family) for club membership – each participant MUST be a member of our club. Children 18 and over must join the club and register individually. 4. Return to club representative listed below.

I wish to join your club and join I am already a member. This is Check one: you in crossing the Mackinaw my registration form for the Bridge Parade & Show. Mackinaw Bridge Crossing. NO – John Deere H, L, LA; Farm All Cub, Low Boy; Massey Harris Ponies; and others not factory-rated to run 10 miles an hour. Exceptions will be on a tractor-by-tractor basis on a test track during the show in June. Contact your rep with questions. Club Representative: Benjamin Camp 18865 V Drive N, Olivet, MI 49076 269-420-8712 Email: [email protected] Club Web Site: www.kalvalleyclub.org Fill out information below completely. We must have an address and phone number so we may contact you with any updates or changes. Email is the preferred contact method. - TO BE RETAINED FOR CLUB REFERENCE

NAME: ADDRESS:

CITY: STATE: ZIP:

PHONE: CELL:

EMAIL: PLEASE READ CAREFULLY

If your tractor make and/or model, driver, or buddy rider change before the event, let your rep know ASAP. Children over 18 are adults and must join the club and register individually. No People Movers allowed in the bridge crossing parade. All buddy rider seats must be approved before July 15th. Please visit http://www.mackinacbridgecrossing.com/ and read the Complete Rules & Regulations before completing the required participant form

Please complete one participant form per participant (see next page). This includes one form per driver and one form per buddy rider. This will be sent to Owosso Tractor Parts. You must complete the participant form and turn into the club representative along with payment in order to be eligible to cross, no exceptions! You can mail, email, or bring the completed forms to one of the club meetings. See our website for meeting location and time. Thank you for joining us for 2017! 2017 Participant Form Mackinac Bridge Antique Tractor Crossing

One form required for each tractor driver or buddy rider of the 10th Annual Mackinac Bridge Antique Tractor Crossing.

Turn this form into your club rep or mail it to Owosso Tractor Parts 6990 W M21 Owosso, MI 48867.

This form is also available to be filled out online at http://www.mackinacbridgecrossing.com/ *Required Field

Email address * First & Last Name *

Name of Club You're Crossing with (You must belong to a club If you need one, please contact us) *

Kalamazoo Valley Antique Engine & Machinery Club

Participant Phone Number (with area code) * Year, Make & Model of Tractor *

Are you a driver or a buddy rider? * Mark only one oval.

I am a tractor driver (must be 18+ years old by September 8, 2017)

I am a buddy rider, next to or behind the driver (must be 16+ years old by September 8, 2017) I am a buddy rider, behind the driver (must be at 13+ years old by September 8, 2017)

Are you 18+, 1617 or 1315 years old? * Mark only one oval.

I will be 18+ by September 8, 2017

I will be 1617 by September 8, 2017 I will be 1315 by September 8, 2017

Who are you riding with? * (If tractor driver and not buddy rider, put N/A")

I have read, understand and agree to follow all rules and regulations of the event. Failure to abide by the rules and regulations may result in disqualification for this, and future Crossings. * Check all that apply.

I am a tractor driver and I understand I must be 18+ years old and agree to the above statement I am a buddy rider and agree to the above statement. I understand that I must be 16+ years old to ride next to the driver and 13+ to ride with an adult behind the driver. I understand my seat must be preapproved by my club and Owosso Tractor Parts in order to participate. There will be no refunds on unapproved seats.

Type Your Full Name for Signature (if under 18, parent or legal guardian must sign) *

Date of Signature *