Motorcycle Poker Run - Dinner Only Please enable JavaScript in your browser to complete this form.Please use the form below pre-order dinner for the poker run. Contact Michelle Worthington kcsomworth@gmail.com) if you have any questions. Number 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? I Want To Order ShirtsYesNoNumber of Shirts (Can pick multiple sizes)1234Shirt 1 Size *Small - $20.00Medium - $20.00Large - $20.00XL - $20.002XL - $20.003XL - $20.004XL - $20.00Shirt 2 Size *Small - $20.00Medium - $20.00Large - $20.00XL - $20.002XL - $20.003XL - $20.004XL - $20.00Shirt 3 Size *Small - $20.00Medium - $20.00Large - $20.00XL - $20.002XL - $20.003XL - $20.004XL - $20.00Shirt 4 Size *Small - $20.00Medium - $20.00Large - $20.00XL - $20.002XL - $20.003XL - $20.004XL - $20.00Any 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 *CardName on CardEmail - CC Holder *Submit Back
