User account

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.
A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Copy the characters (respecting upper/lower case) from the image.
Bumper sticker:

"All the parts falling off this car are of the very finest British