Please follow these instructions to print and send in your form:

DO NOT PRINT THIS PAGE - submitting this page will not register you for the event.

  1. Complete the registration form to the end, filling out all required fields
  2. You may choose to register another H.O.G. Member or Non-Member Guest by clicking the appropriate button after the first H.O.G. member information.
  3. Push "CREATE FORM"
  4. Wait for your Print Window to pop up THEN you can hit PRINT
  5. The mailing address appears on a COMPLETED form which you printed. Mail form and check to the address listed

PRICES INCLUDE ALL APPLICABLE TAXES.
REGISTRATIONS ARE NON REFUNDABLE AND NON TRANSFERABLE.
FIRST H.O.G. MEMBER INFORMATION
* Required Fields
H.O.G. Member
*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
*Country:
*Phone:
Please format phone# like this: xxx-xxx-xxxx
Email:
*National H.O.G. number:
H.O.G. number is two letters followed by seven digits.
For example, US1234567
*Expiration Date:
Local H.O.G. Chapter:
(Optional)
If you'd like to register an additional H.O.G. Member or Non-Member Guest, please choose one of the options below and fill out the appropriate information.

       
REGISTRATION SUMMARY
Prices include all applicable taxes.
- H.O.G Members - $25.00 each
(Includes pin only)		 $
- Non-Member Guest - @ $30.00 each
(No pin included)		 $
ADDITIONAL ITEMS
Children Under 14 FREE
Official Men's State Rally T-shirts:
Small - $15.00 each $
Medium - $15.00 each $
Large - $15.00 each $
XL - $15.00 each $
2XL - $15.00 each $
3XL - $15.00 each $
Official Ladies Scoop Neck Garments:
Small - $15.00 each $
Medium - $15.00 each $
Large - $15.00 each $
XL - $15.00 each $
2XL - $15.00 each $
Official State H.O.G. Rally Patch - $6.00 each $
Official State H.O.G. Rally Ball Cap - $15.00 each $
Additional State H.0.G. Rally Pins - $6.00 each $
Number competing in the Wednesday Poker Run FREE
Number attending the Wednesday night Early Arrivals Party
at Pelican Beach Resort 		FREE
Number competing in the Thursday Poker Run FREE
Number attending the Thursday Night Bike Night
FREE PIZZA EVENT AT HELEN BACK CAFE 		FREE
Number of bikes in the Motorcycle Parade on Saturday
You must supply your own flag pole. 		FREE
Total Amount Due
(Includes all applicable taxes)		 $ 
To complete your registration, click the Create Form button. Print and mail the resulting form. DO NOT PRINT THIS PAGE.