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SOUTHERN CRUISERS RIDING CLUB WV STATE RALLY 2020

SUMMERSVILLE, WEST VIRGINIA - JUNE 11TH 12TH 13th
Name *

First Name Last Name
RALLY REGISTRATION SHIRT SIZE select only one per registration please *

SMALL Med LARGE 1X 2XX 3XXX 4XXXX
Chapter Name & Number
E-mail *
example@example.com
Emergency Phone number *

Area Code Phone Number

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

FOR PAYMENT BY MAIL:

PLEASE PRINT FORM AND SEND COPY WITH YOUR PAYMENT - PLEASE DO NOT SEND CASH THROUGH THE MAIL - DO NOT USE SUBMIT BUTTON -

MAKE CHECK TO: WEST VIRGINIA STATE RALLY

MAIL TO:

West Virginia State Rally

183 Crystal springs rd

Elkins wv 26241

CREDIT CARD - PAYPAL - USE SUBMIT BUTTON
Rally Registration rally 2020

Registration $ 35.00

extra shirt SMALL $ 15.00

extra shirt MED $ 15.00

extra shirt LARGE $ 15.00

extra shirt 1X $ 15.00

extra shirt 2XX $ 15.00

extra shirt 3XXX $ 15.00

extra shirt 4XXXX $ 15.00

Total $ 0.00

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