25th Annual Rocky Bow Lunatic Fringe Rally

July 13th ~ July 15th 2012

Registration Form

Name:__________________________________________________________________

Passenger/Second Rider:____________________________________________________

Address:________________________________________________________________

City:____________________________________________________________________

Province/State:___________________________Postal/Zip code____________________

Phone Number:___________________________________________________________

E-mail Address:___________________________________________________________

Rocky Bow BMW Riders and its members assume no responsibility for loss, damages, or injury incurred through travel to or participation in this event.

Signature:_________________________________________________________

Passenger/Second Rider:______________________________________________

Please fill in the above information and mail it along with the appropriate fee to:

                Rocky Bow BMW Riders
                78 Eldridge Rise
                Airdrie, Alberta
                T4B 1C4
                Canada

For further information please contact Magda at (403) 912-0837

Fees:
Pre-register by July 1st, 2012 and pay only:         $45.00 US/CAD
Registration at the gate    :                $50.00 US/CAD

Fill out the information below for Rally awards:
Mileage: ______________________Km or ______________Miles

Age:__________________ Male:________ Female:__________

Motorcycle info: Make:___________Model:__________ Year:__________