Motorcycle Poker Run - Dinner Only Please enable JavaScript in your browser to complete this form.Please use the form below to register for the poker run. Contact Michelle Worthington kcsomworth@gmail.com) if you have any questions. LayoutNumber of Guests for Dinner Only1 - $20.002 - $40.003 - $60.004 - $80.00Name #1 *FirstLastDinner Choice - Please Choose 12 Piece Porkchop Dinner2 Piece Chicken DinnerCombo Dinner (1 of Each)Choice of dinners.Name #2 *FirstLastDinner Choice - Please Choose 1 2 Piece Porkchop Dinner2 Piece Chicken DinnerCombo Dinner (1 of Each)Choice of dinners.Name #3 *FirstLastDinner Choice - Please Choose 1 2 Piece Porkchop Dinner2 Piece Chicken DinnerCombo Dinner (1 of Each)Choice of dinners.Name #4 *FirstLastDinner Choice - Please Choose 12 Piece Porkchop Dinner2 Piece Chicken DinnerCombo Dinner (1 of Each)Choice of dinners.Want to Buy Shirts or Pay for Bags Tournament? LayoutI Want To Order ShirtsYesNoI Want To Pay For Bags TournamentYesNoLayoutNumber of Shirts (Can pick multiple sizes)1234Shirt 1 Size *Small - $18.00Medium - $18.00Large - $18.00XL - $18.002XL - $18.003XL - $18.004XL - $18.00Shirt 2 Size *Small - $18.00Medium - $18.00Large - $18.00XL - $18.002XL - $18.003XL - $18.004XL - $18.00Shirt 3 Size *Small - $18.00Medium - $18.00Large - $18.00XL - $18.002XL - $18.003XL - $18.004XL - $18.00Shirt 4 Size *Small - $18.00Medium - $18.00Large - $18.00XL - $18.002XL - $18.003XL - $18.004XL - $18.00Number of Bags Participants Paying For1 - $20.002 - $40.003 - $60.004 - $80.00Player 1 Name *FirstLastPlayer 2 Name *FirstLastPlayer 3 Name *FirstLastPlayer 4 Name *FirstLastAny special information you would like us to know?Payment Please complete the payment section below to register for event. If you need to pay by check or other means, please contact Michelle Worthington at (kcsomworth@gmail.com) Total$0.00Enter Credit Card *This page is insecure. Credit Card field should be used for testing purposes only.CardName on CardEmail - CC Holder *Submit7409 Back
