Registration form Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required)Email(Required) Package(Required) One Complete Package One Lane Sticker Only One Complete Package(Required)SMMDLGXL2XL3XL4XL24th ANNIVERSARY COMPLETE PACKAGE $35 (while supplies last) INCLUDES: *One official 3” x 4” Cruise Lane Sticker *One official color wood plaque with Cruisin’ Gratiot logo and sponsor plates *One official Limited Edition Logo T-Shirt *One official event dash plaque *One official bag with Logo Note: Package Number Assignment is based on the date when your fully-paid registration is received. Packages cannot be mailed. A postcard will be mailed to you with your Package Number Assignment, shirt size, and pick-up dates and locations.One Lane Sticker Only (Pre-Cruise) Quantity(Required) Price: $15.00 Quantity Includes: *One official 3” x 4” lane sticker. You MUST include a self-addressed stamped envelope (SASE) with your payment. If you do NOT include a SASE, we will mail you a postcard with pick-up dates and locations. You MUST then present the postcard to pick up your lane sticker. If you lose the postcard or forget your pass at home you will be responsible to purchase a new one!Would you like to purchase additional official 2023 logo t-shirts? Yes No SM Quantity Price: $20.00 Quantity MD Quantity Price: $20.00 Quantity LG Quantity Price: $20.00 Quantity XL Quantity Price: $20.00 Quantity 2XL Quantity Price: $20.00 Quantity 3XL Quantity Price: $20.00 Quantity 4XL Quantity Price: $20.00 Quantity Total Payment(Required) I understand I have to mail my payment (and SASE if applicable).Make Check payable to "Eastpointe Cruisin Gratiot" Mail Check to: Kathy Wodecki Eastpointe Cruisin’ Gratiot 17640 Collinson Eastpointe, MI 48021 Please mail your payment by June 5,2023 to allow time for mailing No Refunds – Eastpointe Cruisin’ Gratiot will go on Rain or Shine.