Beer~ Food~ Prizes~ Raffles

Registration: 4th Annual Take Jake Car Show Contact us

June 14, 2014 at 10:00am
Grizzly Rose for
$15 Pre 5450 N. Valley Hwy
Denver, CO 80216 informatio
Register n on
hosting a
$20 Day Of vendor
booth!

100% OF ALL PROCEEDS GO TO THE JAKE THOMPSON GIFT OF LIFE

SCHOLARSHIP
Checks can be made out to Take Jake Inc. and can be mailed in along with this application to Take Jake 5590 High St. Denver, CO
80216 Attn: Tarryn.

Please feel free to look more into our organization, how it started and what we stand for at www.takejake.org or find us on Facebook
at: Take Jake.

Take Jake is a non-profit 501c3 charitable organization and designed to promote and educate the community of the importance of
organ and tissue donation, and to contribute to the Jake Thompson Gift of Life Scholarship.

Application Name:______________________________________________________________________________________
Street Address:_________________________________________________________________________________________
City: __________________ State:________ Day of the Event Phone:_____________________________________________
Email Address:_________________________________________________________________________________________
Club Affiliation:_________________________________________________________________________________________

Make:________________________ Year:____________________________ Model:__________________________________

Please Circle one: Import Modern Muscle Classic Muscle Street Rod Motorcycle
Pick Up 4x4 Pick Up Race
All Out Custom/Rat Rod

I hereby waive and release Take Jake inc, and The Grizzly Rose from any liability, for illness, injuries, losses, damages or judgments
incurred during the Car Show Event. Participants assume all responsibilities and liabilities.

Signature of Entrant:____________________________________________________________

Questions please contact: Tarryn Thompson 303-641-2025 or at Tarrynt@colopetro.com

Amy Fabiano 720-289-6266 or at Amy.Fabiano@gmail.com

www.takejake.org