POKER RUN REGISTRATION FORM

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					                       REGISTRATION FORM



NAME: _________________________________

ADDRESS:______________________________

PHONE:_________________________

EMAIL: _____________________________

TYPE OF BIKE: ________________________________
                    YEAR/MAKE/MODEL


Cancun Cantina, Red Eye Dock Bar, Bamboo Bernie’s, Anne Arundel
County Burn Foundation and 98 Rock as well as all participating
establishments are not to be held liable for any damage and/or theft on or off
the property that may occur on this day, August 23, 2008.

By signing below, I agree that I have my own motorcycle insurance and that
I have read and understand the information regarding liability.




Signature of Rider:_________________________

Passenger:________________________________

				
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