Presented by: Central New York PT Cruiser Owners Club, Inc.
Sanctioned by: Chrysler Owners Group
Registration Form
Name: _________________________________________________________________________________
Guest(s) Name: _________________________________________________________________________
Address: _______________________________________________________________________________
City: __________________________________State: __________________Zip: ______________________
Phone Number: _________________________ Cell Phone: _______________________________________
Email: ____________________________________________________________________________________
Year of PT: ______________________Model: _____________ Color: ________________________________
Class: Original:________ Stock: _______ Mild Custom : ______ Extreme Custom: ________
Please send entry to:
Cathy DeWolf
Central NY Director
PT Cruiser Owners Club
26 Lee Terrace
N. Syracuse, NY 13212
Additional information, please call: 315-458-1796 or e mail me at: CNYPT@verizon.net
Show use only: Date: ________ Check #:_______Entry #:_________