May 1, 2010 Poker Registration

You can register right here or at Active.com. Cost for preregistration is only $12. The day of the event you will be able to register but the cost will be $20. So please register early and help spread the word. The person who refers the most people will receive a cool prize.

Our goal is to have over 200 riders this spring and over $3,000 for Dilworth Middle School.

Fat Boy Biking Poker Run On-Line Registration

Please note that all fields followed by an asterisk must be filled in.

Hold Harmless Agreement*
Hold Harmless Agreement*

Yes I have read the Hold Harmless Agreement and by checking the box I accept the terms.

Payment*
Payment*

Yes - I understand that registration is not complete until I pay through the Pay Pal account or send check/money order to Fat Boy Biking.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address

City

State/Prov

Zip/Postal Code

Home Phone*
Home Phone*

Emergency Contact Information - Please list Name and Cell Number*
Emergency Contact Information - Please list Name and Cell Number*

Person To Thank

T-Shirt Size*
T-Shirt Size*

Please enter the word that you see below.