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Medford Cruise Online Registration Form
In celebration of our 25th anniversary, we've made event registration on our website easier.
Just fill out this one form, and all of your event registration and merchandise requests
will be handled securely in a single transaction via Pay Pal.
Still old school? Just
download our new printable form
, fill out and send to:
PO Box 629 Medford OR 97501
Entrant Information
(required fields)
First Name
Last Name
Address
City
State, Zip
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
MS
LA
ME
MD
MA
MI
MN
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Email
Phone
Car Club
Returning Entrant?
Yes
No
Address Change?
Yes
No
C
ontact me about vendor booth space
Event Registration
(required fields)
Medford Cruise includes T-Shirt, Dash Plaque, Sat. & Sun. Show n' Shine, Concert and Cruise
and 1 Poker Run Hand
Requirements: Vehicle must be 1972 or older
Register for Medford Cruise June 19 - Entry Fee:
$40 per car
Select Shirt Size
M
L
XL
XXL
XXXL
I will also be showing at the Unlimited Show 'N Shine June 20
(Free with Medford Cruise Registration)
Register for Unlimited Show 'N Shine June 20
Only
- Entry Fee:
$10
NOTE:
Unlimited Show 'N Shine is
FREE
with Medford Cruise Registration - any make / model plus motorcycles
Register for Drift Evolution June 12-13 - Entry Fee:
$75
(Please fill out required information below)
Car 1
Car 2
Make:
Make:
Model:
Year:
Model:
Year:
Car 3
Car 4
Make:
Make:
Model:
Year:
Model:
Year:
Drift Evolution Event Required Information
Is this car registered for highway operation?
Yes
No
LSD
Yes
No
Engine Spec:
Turbo / Aspiration:
Suspension:
Sponsor Information:
Team:
Special Modifications:
Driver history, milestones and championships for individual, team and sponsors / length of competitive drift / racing experience:
How did you hear of this event?
Additional Event Tickets and Merchandise
Drift Evolution Spectator Tickets June 12-13
| $5 each | Enter qty:
Exhibit my car at the June 17 Kickoff Show N' Shine
| FREE | Any make/model | Enter number of cars:
Scenic Poker Run June 18
| $5.00 per hand (First hand free with Cruise Registration) | Enter additional hands:
Participate in June 18 Drag Races
| $25.00 per car | Enter number of cars:
Vehicle must be 1972 or older - mandatory safety inspection and approved crash helmet also required
Spectator Ticket(s) to Drags June 18
| $10.00 each | Enter qty:
I would like to ride in a Shelby Cobra - Time Trials June 18
Rides $20.00 each |
Limit 2 rides (1 rider - 2 rides
or
2 riders 1 ride each)
|
1 Ride
2 Rides
I would like Pancake & Egg Breakfast Tickets |
$6.00 each |
Saturday
qty:
Sunday
qty:
I would like to participate in the Medford Poker Walk June 19 |
$5.00/hand | Enter hands:
I would like to attend the 25th Anniversary Evening with Elvis
| Tickets $15.00 each | Enter qty:
I would like to purchase additional 25th Anniversary T-Shirt |
T-Shirts $20.00 each
Medium | Enter qty:
Large | Enter qty:
X Large | Enter qty:
XX Large | Enter qty:
XXX Large | Enter qty:
I would like to purchase additional 3-Pack of vintage Cruise T-Shirts |
$20.00 each - quantities limited
Small | Enter qty:
Large | Enter qty:
X Large | Enter qty:
I would like to purchase 25th Anniversary Magnet Plaque
| $3.00 each | Enter qty:
I would like to purchase 5-Pack of vintage Cruise Magnet Plaques
| $5.00 each | Enter qty:
I would like to sponsor a trophy
| $50.00 each | Enter qty:
I would like to donate to Medford Cruise
| Donation Amount:
$20
$30
$50
$100
I would like to purchase 25th Anniversary Letterman's Jacket - Style One: Wool & Leather - $283
Medium | Enter qty:
Large | Enter qty:
X Large | Enter qty:
XX Large | Enter qty:
XXX Large | Enter qty:
I would like to purchase 25th Anniversary Letterman's Jacket - Style Two: The Contender - $183
Medium | Enter qty:
Large | Enter qty:
X Large | Enter qty:
XX Large | Enter qty:
XXX Large | Enter qty:
I would like to purchase 25th Anniversary Letterman's Jacket - Style Three: Blue Denim - $183
Medium | Enter qty:
Large | Enter qty:
X Large | Enter qty:
XX Large | Enter qty:
XXX Large | Enter qty:
Submit Form
Registration Total: