<p> Southern Cruisers Riding Club KENTUCKY STATE RALLY Lexington, Kentucky June 11-13, 2004 REGISTRATION FORM</p><p>(ONE FORM PER PERSON PLEASE)</p><p>Pre-registration for the 2004 Kentucky State Rally is strongly encouraged by May 11 th. The on-site registration fee will be on a per event basis to be collected at on-site registration and check-in. Pre- registration of rally events will ensure the Lexington Chapter has an idea of the numbers who plan to attend and to determine the number of t-shirts and patches to order. </p><p>Last Name:______First Name:______</p><p>SCRC Chapter: ______Rider OR Passenger </p><p>Street Address: ______</p><p>City:______State:______Zip:______</p><p>Telephone:______Email:______</p><p>ALL PROCEEDS WILL GO TO ST. JUDE’S CHILDREN’S HOSPITAL; no refunds.</p><p>Rally Events & Fees (Please mark the events you plan to attend): Friday Ride - FREE Saturday SHORT Poker Run - $5/hand or $12/3 hands</p><p>Saturday LONG Poker Run - $5/hand or $12/3 hands Bike Games - FREE </p><p>Patch & T-shirt - $15.00 (to ensure you get a t-shirt and patch, please pre-register by May 11th): T-Shirt Size: S M L XL 2XL 3XL 4XL</p><p>Fees for the following events will be taken at the time of the actual event, not at the registration table. Bikini Bike Wash - $5.00 Bike Show - $5.00 Tattoo Contest - $2.00</p><p>Please either e-mail form to: [email protected] OR Snail mail form to: Scott Lawson 117 Stanley Lane Nicholasville, Kentucky 40356</p><p>Please keep a copy of this form for your records, thank you.</p>