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Desert Dash Rally Registration Form

August 15, 16, 17 2008

www.hcdesertdashrally.com

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

Make: Year: State:
Model: Color: License:
  • Pre-registration _________ _____________________________@ $35.00........................$______
  • Additional T-shirts @ $18.00 for S-M-L & $20.00 for XL+ ..........................#_________size.........$______
  • 2XL & 3 XL @ $18.00.............................................................................#__________size..........$______
  • Additional run pins @ $5.00.....................................................................#_________pins.........$______
  • Additional Poker Hand @ $10.00................................................................................................$______
  • Saturday Night Dinner $10.00..................................................#_________ dinners...................$______
  • Total due with registration..................................................................................................Total $______