GRAINGER HUMANE SOCIETY`S RIDE 4 PAWS & CLAWS

GRAINGER HUMANE SOCIETY`S RIDE 4 PAWS & CLAWS
ANNUAL MOTORCYCLE RUN & RALLY

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REGISTRATION FORM


 

 

 

REGISTRATION FORM

*********Copy & Paste to fit on 1 page*************

Registration For GCHS Ride For Paws & Claws 2009
Pre-Registration Form for 1 Bike with Rider / 1 Bike with Rider & 1 Passenger

Rider’s Full Name_____________________________________________

Address_____________________________________________________

City ______________________State___Zip________________________

Phone # ________________________Email________________________

Passenger’s Full Name _________________________________________

Address_____________________________________________________

City_____________________State_________Zip___________________

Phone #_________________________Email________________________

*BASIC RIDE PACKAGE -       1 Rider- $15.00_____ 1 Rider & Passenger-$20.00_____
   (Price includes- Ride, K-9Hold'Em Card, Free Anniversary Pin, Gift & Snack)

*DELUXE RIDE PACKAGE -    1 Rider- $25.00_____ 1 Rider & Passenger -$40.00____
(Price includes- Ride, 2 K-9Hold 'Em Cards, 2 Free Anniversary Pin & 2 Shirts, Gift & Snack)

*BIKER MEAL SPECIAL -$6.00 each _______
(BQ pork sandwich, potato salad, baked beans & canned drink)

Prize Drawing #1- $1.00 Each- Rider____________Passenger_____________

Prize Drawing #2- $1.00 Each- Rider____________Passenger_____________

Prize Drawing #3- $1.00 Each- Rider____________Passanger_____________
***PLEASE INCLUDE YOUR SHIRT SIZES!!!!!
Unlimited T-shirt & Tank Top  order allows you to order more shirts for a fee. Please include the extra number of each size wanted.
Shirts will be $10.00 & up while supplies last. Purchase now to ensure you get extras!

T-SHIRT-Adult small___Adult Medium___Adult Large___Adult XLarge___ XXLarge ($12.00each)___XXXLarge ($14.00each)____

TANK TOP- Adult small____Adult Medium____Adult Large____Adult XLarge____ XXLarge ($12.00each)

Make a tax deductible donation to Grainger County Humane Society-$______________ 

Payment Method: Personal Check#________-M.O.#_______________Total Payment Included $_________
 G.C.H.S. , Am Vets Riders and Colboch Harley Davidson are not responsible for any damages, accidents or physical harm of rider, passenger, motorcycle and any other property that might occur during this event. All Prizes must be claimed at the Rally or at Colboch Harley Davidson on SEPTEMBER 19 2009. NO RAIN DATE & NO REFUNDS.

 Rider’s signature______________________________________________________Date______

Passenger’s Signature____________________________________________Date_____

Mail your pre-registration form & make payment to:GCHS ATT: Rocky, 1085 Notch Gap Road, Thorn Hill TN 37881

* For Office use only: rider#________________Passenger#_____________

 

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