NEVADA DISTRICT RALLY
REGISTRATION
JUNE 20, 21, & 22, 2008
Rider Name: ________________________________Co-Rider Name: _____________________________
Rider GWRRA #___________________________Co-Rider GWRRA #___________________________
Address: ____________________________________________________State:
______Zip: ___________
Phone: _________________Cell:
___________________ E-mail: ________________________________
Registration Fees
GWRRA
Member $18.00 each x Total $ _________
Non-Member $20.00 each x Total
$ Total
Registration $ _____________
On site
registration $25.00
Polo
Shirts Sold by Pre-Order/Pre-Paid Cut
off date to order the Polo Shirts is May 20, 2008
Small: $18.00 x
________ Medium: $18.00
x___________
Large: $18.00
x ________X-Large: $18.00
x___________
XX-Large $20.00 x ________XXX-Large $20.00 x___________ Total for
Shirts $ _______________
Masters Breakfast $15.00 x
Total for Masters Breakfast $ _______________________
50/25/25 Tickets indicate by an X Pre-Paid by May 20, 2008, at the rally cost will be 6 for $5.00
____10 Tickets for $5.00
_____25 Tickets for $10.00_____65 Tickets for $20.00 Total $ ___________
Total
Fees Enclosed $_________________________
I the undersigned, agrees to comply with the ideals governing this event and to hold harmless GWRRA, co-sponsoring organizations
and property owners for any loss or injury to self or property in which I/we may become involved and I/we agree to assume responsibility
for any property which I/we knowingly damage.
Rider______________________________________Co-Rider_____________________________ Date: ___________
Make checks payable to
GWRRA Nevada District, mail checks and registration form to Roz