First Name:
Last Name:
Street Address:
City:
State:
 Zip Code:
Home Phone  XXX-XXX-XXXX
 E-Mail Address
Vehicle Production Year
 Free T-Shirt Size
Vehicle Make (Dodge, Plymouth, etc)
Vehicle Model (Charger, Cuda, etc)
Please list your guests so we'll have a name tag
for them and enough refreshments for everyone.
I would like to buy ____ additional Show T-Shirts
at $12.00 each. Please Enter: Quantity; Size

               Legal Notice

By completing and submitting this registration form,
I hereby agree that neither the producer, the sponsors,
First Baptist Church of Shreveport or its members,
nor any members of Mopar Magic Unlimited Auto Club,
Inc. shall be liable for any loss or damage to all or part
of the exhibitor's display and/or vehicle, and the exhibitor
shall and does hereby waive any and all rights he may
have against them or any of them for such loss or damage.
Louisiana Mopar Nationals
22nd Annual Car Show
Saturday, March 23, 2013 Online Registration Form
Open to all Mopar and predecessor company produced vehicles!

ENTRY FEES:

Register Mar 12th or Earlier
$25 first car
$20 second car
$15 third car and beyond

Register Mar 13th or Later
$30 first car
$25 second car
$20 third car and beyond

Please Complete &
Submit One Online
Application per Vehicle.

After Submitting the Online
Registation Form on the Left,
Mail Your Check to:

Mopar Magic
Unlimited Auto Club, Inc.
PO Box 52081  
Shreveport, LA 71135-2081

Lots of Awards! Door Prizes!
First 100 entrants receive a
show t-shirt, a dash plaque,
and a goody bag!

Show Date:
March 23, 2013
NO Rain Date
See you at the Show on  March 23rd!
Complete form, then click the PRINT icon in your browser, and
mail to the above address.

Want to buy an Extra Show T-Shirt?


List the sizes and quantities you want to buy
on your mail-in registration and enclose $12.00
each.  Be sure an get them early, we ran out
last year!

Note - One Free shirt is included with each
registration.
To complete registration, Step 1 is fill out the entry
form; Click Submit; then come back and complete

Step 2, MAIL your check/money order to:

Mopar Magic Unlimited Auto Club, Inc.
PO Box 52081  
Shreveport, LA 71135-2081
A portion of the proceeds of our show will be
donated to the Feist-Weiller Cancer Center at the
LSU Health Science Center in Shreveport.  You may
learn more about them at their website:  
www.feistweiller.org .
STEP 1: YOUR INFORMATION
STEP 2:  PAYMENT
LOCATION:

First Baptist Church of Shreveport
543 Ockley Drive, Shreveport, LA
71106

Registration-8:00 AM
      Judging-11:00 AM         
Awards-3:00 PM