Apparatus Registration

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Apparatus Registration Form

Name *

Email Address *

Telephone *

City*

State *

Zip*

Manufactuer *

Year*

Type and Model *

Ownership *

Privately OwnedFire Department Owned

Registration Fee To Shriners Transportation Fund *

Name on Apparatus *

Will the Apparatus be Driven *

Miles Driven *

Insurance Company *

Policy number *

Effective Date *

I have read the below rules and regulations (in red) *

Yes

Owner or Fire Dept. Officer title or Rank *

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Please follow the link below for payment information. <a href="https://www.massmafaa.com/vendor-paypal">https://www.massmafaa.com/vendor-paypal</a> Please check the home page of https://www.massmafaa.com for the next meeting. We look foward to meeting you. President Brian Anderson Jr. VP Dan Feyler

Make Checks payable to: Shriners Transportation Fund Early registration is advisable !!!!

Please read the following safety rules;

OWNERS/OPERATORS ARE RESPONSIBLE FOR CONTAINING, CLEANING UP & REMOVING

ANY FUEL / OIL LEAKS AND SPILLS FROM THEIR APPARATUS

Proof of insurance and a working approved Class BC or ABC Fire Extinguisher is required

for all Motorized apparatus and Chock blocks are required for all apparatus

(A MA Boiler Certificate is required for any steamer being fired and a MA licensed Fireman is required to operate any steamer)

This years show registration will directly supporting Shriners Hospitals for Children® we will be accepting donations toward the dash plaques and trophy's. Every registered truck will receive a dash plaque

We request that you do not leave the show site with your apparatus until 2:00 PM.

NO DOGS, BIKES, ROLLERBLADES or SKATEBOARDS

WILL BE PERMITTED ON THE SHOW/FLEA MARKET SITE!

I (we) hereby certify that each and every apparatus entered by me (us) is road worthy according to the requirements of

the State in which it is registered and is covered by proper liability, personal injury and property damage insurance.

In addition to complying with the above Rules and Regulations,

I (we) agree to indemnify and hold harmless MAFAA, Inc., SPAAMFAA and Shriners Hospitals for Children® or the owner and/or

management of the property on which this event is held against all claims, demands, judgments, suits or actions for injury or damage alleged to have been sustained by any party arising out of our participation in this event.

I (we) also agree to read and abide by the MAFAA Safety Rules provided in RED above.