HOT N' FUNKY Festival 2005

Registration Form

International ArtCar Show

Friday August 12, Saturday August 13 & Sunday, August 14, 2005

ArtCar Artists: Michelle Barkay 250.754.6933 michelle@gypsymermaid.com

ARTCAR Artists Registration:

Name of ARTCAR : ______________________________________________

Your Name: ___________________________________________________

Phone:_________________Email: ________________________________

Fax:_______________Address:_______________________________________________________

Approximate Travel Km/Miles:________________________________________________________________

Date of Arrival: _________________ Date of Departure: __________________

Do you require somewhere to stay?_______________ Special Requirements

(Pets, Allergies, Smoking etc..)_____________________________________________________________________________________

_________________________________________________________________________________________

Please include photo or attach and email jpg of your artcar!

$25 Registration Fee before Aug : If you would be so kind!

(This fee includes your membership with the ARTCAR Society of Canada for the year!)

Payment to: ARTCAR Society of Canada, 214 Kennedy Street, Nanaimo, BC V9R 2H8