Midwest Gay Bikerboys Run

Package Registration

July 8-10,2005

 

Only one registrant per form.  Form may be copied to accommodate additional registrants. Bikerboys reserves the right to approve or reject any application. A limited number of full weekend packages available at this price.

 

Incomplete form will not be processed

 

 

Name:  _______________________________________________________

 

Address:  _____________________________________________________

 

City, State, zip:  ________________________________________________

 

Telephone:  _________________  email:  ___________________________

Name to appear on badge:________________

Club affiliations (if any):  ______________________________

 

Weekend package $70.00 ( excluding hotel) before or on July 1,2005

$80.00 after July 1,2005

Friday Welcome Party/ Friday Midnight Run/ Saturday Morning Run/ Saturday Bikerboys Picnic, food ,beer / Bikerboys Blowout Party / After Hours play party

 

T shirt size          __ med  __large  __xl  __2X  __3X

 

early registration $60.00 must be postmarked before or on June 1, 2005

                                                $80.00 after June 1,2005

__ CASH (in person registration only,do not mail)    ___CHECK ( mail in, before June 30,05)

only cash or money order accepted the day of events July 8-10,2005

 

Mailing Address : Bikerboys

                                6379 Viewmont Dr

                                Dayton, Ohio 45415

 

I certify that I am at least 21 years of age and that I will abide by all laws, rules, and regulations pertaining to this event .I will hold blameless Bikerboys Social Club, and its members, event sponsors and all persons associated with this event  for any damage or injury to my property or myself.

 

Signature____________________________________________________________

 

Cancellations and / or name changes subject to a $30.00 processing fee. No changes or refunds after June 15, 2005