REGISTRATION - PLEASE MAIL BY JUNE 26
Registration must be postmarked by June 26, 2003.
There will be no registration at the gate.
Name ________________________________________________________
Address ______________________________________________________
City/State/Zip _________________________________________________
Phone, Best time to call? _(______)_______________________________
Marque Entered ________________ Model ______________ Year ______
Club affilliation (not necessary for entry) ____________________________
REGISTRATION FEE: $25.00
(Includes: Poker Rally, one “Rally In the Valley” Polo Shirt and Natter ‘n’ Noggin)
Circle size for Polo-Shirt:
2XLG XLG LG MED SM (2XL add $4.00)
Extra Shirt: $18.50ea
Circle size for Shirt:
2XLG XLG LG MED SM (2XL add $4.00)
Total __________________ (Make Checks payable to Diane Rindt)
Send to: Diane Rindt, 4271 North Shore Drive, Eau Claire WI 54703
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