Centralia Halloween Parade Entry Request Form
Point of contact person *

First
Last
Email *
Address *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Phone Number *

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The theme for the entry is ( Name Entry - Or How it will be Published) *
Will the unit include sound, music or otherwise: *
 Yes 
 No 
Entry Length Ft
Entry Width Ft
Type of Entry *
Category *
Upload Copy of Insurance Card
ALL VEHICLES MUST SUPPLY COPY OF INSURANCE CARD & LEGAL AGE TO OPERATE
I have read and agree to the Terms and Rules of the Centralia Halloween Parade *
 Yes, I agree. 
Indicate any others here or any extra needed info

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