2ND ANNUAL

POKER RUN June 23, 2012 - Rain or Shine

Ride Starts and Finishes at Fleetwood Park West Main Street * Fleetwood, PA

First Bike Out at 10:00AM * Last Bike Out at 12:00PM * All Bikes In by 3:30PM Band Together to Fight Breast Cancer event at park from 12:00PM -7:00PM
check facebook.com/BandTogetherEvent for details and updates to the ride and the event!

Pre-register by May 31st - $20 per Hand * Day of Ride - $25 per Hand
* Registration Includes 1 food/refreshment ticket per hand purchased * * Pre-registration also includes an event T-shirt per hand purchased * * Cash prizes for 3 best hands and the worst hand *

All Profits from Ride donated to Breast Cancer Support Services of Berks County

------------------------------------------------------------------------------------------------Rider Name (print):__________________________________________ Telephone: ( ) ____ - _______ Address: street:____________________________________city:____________________state:_______zip code:________ Number of Pre-registered Poker Hands _____ @ $20 (includes food ticket & T-Shirt when received by May 31,2012) Number of Day-of-event Poker Hands _____ @ $25 (includes 1 food ticket per hand) T-shirt Size/Count: S ___ M ___ L ___ XL ___ XXL ___
(total count to equal # of hands purchased)

Make checks payable to: Band Together To Fight Breast Cancer Mail to: Band Together Breast Cancer Ride * 496 Eagle Road * Kutztown, PA 19530

The undersigned hereby acknowledges that motorcycle riding is an inherently dangerous activity and agree to release, indemnify and hold harmless all owners, promoters, lessee and tenants of all premises, for any loss, injury or damage to property which may be sustained as a result of participation in this motorcycle run.

Passenger Name (print):_____________________________ Rider signature:_________________________ Passenger signature: ______________________________