Poker Run Registration Form 2010
1ST ANNUAL ZACHARY BRIAN HOOPER MEMORIAL SCHOLARSHIP FUND DAFFODIL POKER RUN
ALL PROCEEDS GO TO THE MEMORIAL SCHOLARSHIP FUND

DATE: MARCH 13, 2010
REGISTRATION TIME: 8:00 A.M. TO 9:00 A.M.
AT VFW PARKING LOT EAST CAMDEN
PRE-REGISTER UNTIL MARCH 5th  $20.00 BIKER/$5.00 RIDER
DAY OF EVENT $25.00 FOR BIKER/$10.00 RIDER
ADDITIONAL CARDS MAY BE PURCHASED FOR $5.00
MAPS PROVIDED DAY OF THE EVENT

FREE EVENT T-SHIRT TO THE FIRST 50 PARTICIPANTS
PRE-REGISTRATION ENSURES SHIRT SIZE AVAILABILITY
ADDITIONAL SHIRTS CAN BE PURCHASED THE DAY OF EVENT FOR $15.00

PRIZE AWARD WILL BE DETERMINED BY PARTICIPATION
 BEST POKER HAND

FIRST BIKE OUT 9:30 A.M./LAST BIKE OUT 10:30 P.M.
FIRST BIKE IN 2:00 P.M./LAST BIKE IN 2:30 P.M.
PRIZE AWARDED AT 3:00 P.M. DOWNTOWN AT THE FESTIVAL
71.5 MILES/RIDE TIME 2 HOURS
.
BIKER NAME__________________________EMAIL___________________________

RIDER NAME__________________________EMAIL___________________________

ADDRESS BIKER________________________________________________________

Liability Release:  I agree not to hold any organizer, contributor or property owner associated with this event responsible for loss to myself or property by participating in this event.
Signature:________________________________________Date___________________

Signature:________________________________________Date___________________
(Adult Signature Required for Minors)

EARLY REGISTRATION FORMS MUST BE RECEIVED BY MARCH 5th.
TO:  DOTTY HARRIS RT. 4, BOX 138A-1 CAMDEN, AR 71701
FOR MORE INFORMATION CALL 870-836-2210, 870-574-2158 OR EMAIL doharris@cablelynx.com