Danny

| Home | About Dan | Scholarship | Ride & Run | Sponsors |Contact Us |

Click here for printer friendly version.

REGISTRATION
Motorcycle Ride & Poker Run
Pre-Registration Appreciated
Name:_____________________________________________
Address:___________________________________________
__________________________________________________
City:______________________
State:____________ Zip:______
Phone: (____) _____-________
*Rider $20x______= $__________
Passenger $10x______= $__________
T-Shirt (S) $10x______= $__________
T-Shirt (M) $10x______= $__________
T-Shirt (L) $10x______= $__________
T-Shirt (XL) $10x______= $__________
T-Shirt (XXL) $12x______= $__________
By Preorder Only
Total            = $__________
Make checks payable to:
Dan Stitt IV Memorial Fund
Mail registration and checks to:
Daniel E. Stitt, IV
Memorial Scholarship Fund, Inc.
336 Arnold Avenue
Leeper, Pennsylvania 16233
Questions?
814-744-5434 or
hstitt@verizon.net
*PLEASE NOTE: Riders who pre-register by June 11th can deduct $3.00 from their rider cost.

| Home | About Dan | Scholarship | Ride & Run | Sponsors |Contact Us |

©Daniel E. Stitt IV Memorial Scholarship Fund
Created by Kaleb Smith