Desert Dash Rally Registration Form
August 20, 21, 22 2010
Complete the registration form and return to the address below
Registration is $35 per person
Submit mailed registrations to: Desert Dash Rally P.O. Box 907 Hines, Oregon 97738
Phone: (541) 729-4233
Registration to the Desert Dash Rally includes:
· Run T-shirt & Run Pin (1st 250)
· Admission to all live music events at the Park
· Entry in any all field events/games
· Poker run hand ($400 purse)
Name:_____________________________Email:_____________________________
Address:______________________________________________________________
City:_________________________State:___________________ Zip:_____________
Phone (____)_______________
T-Shirt size: circle one S M L XL XXL XXXL
Name:_____________________________Email:_____________________________
Address:______________________________________________________________
City:_________________________State:___________________ Zip:_____________
Phone (____)_______________
T-Shirt size: circle one S M L XL XXL XXXL
Vehicle Information
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Year: |
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Model: |
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· Pre-registration _________ _____________________________@ $35.00.......................$______
· Additional T-shirts @ $18.00 for S-M-L-XL……............................#_________size........$______
· 2XL & 3XL @ $20.00...............................................................#__________size..............$______
· Tank Top @ $15.00 for S-M-L-XL(limited quantities available please preorder)#____size.$____
· 2XL & 3XL @$18.00 (limited quantities available please preorder ...#_______size………..$____
· Additional run pins @ $5.00.........................................................#_________pins...........$______
· Additional Poker Hand @ $10.00......................................................................................$______
· Saturday Night Dinner $15.00 pp..................................#_________ dinners...................$______
· Total due with registration.......................................................................................Total $______