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Free Legal Guardian Form - Excel

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					                                                     Phoenix International Touring Society (PITS)
                                                                   P.O. Box 21514
                                                                Mesa, AZ 85277-1514
                                                               www.azbeemers.org


                                                           May 16-18, 2003
                                                         Camp Shadow Pines                                                  Heber, AZ 2003

    2003 PITS Roadrunner Rally
                   Registration Information ( Please Print Clearly)
Participant(s) Information
  Rider                           Street Address                              City, State, Zip Code                       M/F     Birth Date


  Passenger/2nd Rider             Street Address                              City, State, Zip Code                       M/F     Birth Date


  Telephone Number                Club Affiliation                            E-Mail Address



  Rider M/C Make                  Year / Model

                                                                                   This form also may be completed
  2nd Rider M/C Make              Year / Model

                                                                                   on your computer using Excel.
  Required Information


                                   Rally Costs if Registration is Postmarked:
                                                        Before May 1, 2003                                         After May 1, 2003
             # of Adults 16 and older:                  @$35.00   =    $            -                             @$40.00    =    $             -
          # of Children between 6-15:                   @$17.50   =    $            -                             @$22.50    =    $             -
             (Children 5 and under are free.)



           Reservations For These Additional Rally Items Must Be Received By May 1
            Reserve a Bunk Bed for each person for 1 or 2 nights; total number of nights:                         @$12.50          =     $      -
                              Reserve your long-sleeved, mock turtle neck 2003 Rally T-shirts:                    @$19.00          =     $      -
  T-shirt sizes: L=               XL=                   XXL=              XXXL=                             Grand Total            =     $      -

For more information, please contact Clint Alston by email at                                  www.azbeemers.org
Make checks payable to: "PITS" and mail the completed form to: P.O. Box 21514; Mesa, AZ 85277-1514. (Sorry, no refunds.)

     I understand that the Phoenix International Touring Society [PITS] cannot assume responsibility for any aspect of my safety and
     that if I participate in this event, I do so voluntarily based upon my own judgment and assessment of my abilities, road/site
     conditions, facilities, and all other risks and potential conditions. I further release and hold the PITS organization, its officers and
     directors, its members and any other person or organizations connected with this event, harmless for any injury or losses to my
     person or property which may result there from. I understand that this means that I agree not to sue the PITS organization, its
     officers and directors, its members and any other person or organizations connected with this event, for any losses I may suffer as
     a result of my participation in this event. No minor may participate without a parent or accompanied by an adult with written,
     notarized authorization from the minor's legal guardian.

                                                     Please, No Firearms or Pets


Rider Signature: I have read and agree to the above release.               2nd Rider/Passenger Signature: I have read and agree to the above
                                                                           release.

				
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