The SCRC Great Lakes Gathering Registration

 

The SCRC Great Lakes Gathering August 1-3, 2008. Sponsored by Southern Cruisers Riding Club Motor City Chapter 454 of Michigan. Proceeds Benefit St. Jude Children’s Research Hospital All participants of the event must fill out the registration form and sign the following waiver regardless if they ride. Dinner will be held rain or shine. A patch is included

Registration: $25.00 per driver and $15.00 per passenger/participant -not riding. Includes Dinner, non alcoholic beverages & door prizes.

Rider Name:_________________________Chapter_________________________ Address:_______________________City________________________Zip_______

Emergency contact: Name_________________________Phone________________

 

Passenger Name:___________________Chapter_____________________

Address: ______________________City: ____________ State: ____ Zip:_______

Emergency Contact: Name_________________________Phone________________

 

Participant Name:____________________Chapter_________________________ Address:_______________________City______________State____Zip__________

Emergency contact: Name_________________________phone________________

T-shirts:

Adult sizes short sleeve $15.00 S_____M_____L_____XL____2XL_____3XL_____4XL_____

Extra Main Event Patch: $5.00 each_______

Write Certified check or money order to Steve Joachim and please put "Great Lakes Gathering" in the Memo section.

E-mail address to send receipt__________________________

Mail Certified Check/ Money Order , Registration form, and Signed Waiver To:

GLG - Steve Joachim

6334 Donnybrook Dr

Shelby Twp. MI 48316