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MAY 16 - 17, 2008
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Registration fee: $25 per person. Two Day Poker run fee: $5 per person (cash prizes)
Includes morning snacks and lunch on Saturday,and live entertainment Friday and Saturday nights Day of ride registration is $25/person, a T-shirt is not guaranteed Prices are $5 each or 5 for $20 |
Pre-register by May 9, 2008 and a T-shirt is included. |
Address______________________ City_____________ State______ Zip___________
Circle: Driver or Passenger Poker Run?____________(yes or no) Add $5 per person
Entry 2___________________________ T-shirt(circle) S, M, L, XL, 2XL or 3XL
Address______________________ City_____________ State______ Zip___________
Circle: Driver or Passenger Poker Run?____________(yes or no) Add $5 per person
Get your tickets now for the Raffle Bike, $5 each, or 5 for $20. Number of tickets_______
Please make check payable to: Wausau Fire-MDA
Print this form and Mail to: 606 E. Thomas Street Wausau, WI 54403
In consideration of the Muscular Dystrophy Association, Inc.'s (MDA) permitting me to participate in the Firefighters Ride for MDA, I hereby release and waive any and all rights and claims I may have against MDA, local 415, all sponsors of this event, and Wausau Fire Department (WFD) in event any injury or damage of any nature, including death, which I may suffer while taking part in this event. I further understand that I assume all risk in participating in this event. Consent is also given to use my name, picture portrait, or video in any promotional purpose for MDA, local 415, sponsors, or the WFD.
Entry 1 signature___________________________ Entry 2 signature___________________________