SATURDAY, MAY 21, 2016

Registration

$25 includes lunchPassenger eligible to purchase an extra poker hand for $25.00 with valid driver’s license. Lunch included.

Registration 8:00 am • Rally begins at 10:00 amFor more information: www.mustangsallyrally.comLunch provided to driver.

Rules

1. MUSTANGS ONLY!5 Best

Poker Hands Win

$500

Co-Sponsors Class Sponsors Lunch Sponsor

presents

4th Annual

Over $17,000 raised for children’s programs

in Sarnia-Lambton!

PRE-REGISTRATION DEADLINE IS MAY 16, 2016

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Registration: $25.00 includes lunch Passenger eligible to purchase an extra poker hand for $25.00 with valid driver’s license. Lunch included.

Please make cheques* payable to: Pathways Health Centre for Children*Post-Dated Not Accepted

Return to:

Mustang Sally Rally c/o Pathways Health Centre for Children 1240 Murphy Road Sarnia, ON N7S 2Y6

For information,call Wendell Drysdale (519) 491-2265or visitwww.mustangsallyrally.com

In consideration of the acceptance of the right to participate, entrants, participants and spectators by execution of the entry form, release and discharge the Pathways Health Centre for Children, City of Sarnia, Lambton Ford, Ford Canada, any other participating sponsors, the Province of Ontario and their officers, employees, agents, representatives and servants and anyone else with unknown damages, injuries, losses, judgements and/or claims from any cause whatsoever that may be suffered by the entrant to his person or property. Further, each entrant agrees to indemnify all of the foregoing entities, firms, persons and bodies of and from any and all liability occasioned or resulting from the conduct of entrants or any participant assistant or cooperating with entrants under the direct control of the entrant.

LIABILITY

Signature: Dated this Day of 2016

Name: Yr/Model/Colour:

Address: Club Affiliation:

City: Email Address:

Prov./State: Postal/Zip Code:

Phone Number: Registering for: Rally ❑ _____ Spots @ $25