WHITE
STAG 2008 APPLICATION FORM
Name ___________________________________________________________________
Address__________________________________________________________________
City, State, Zip____________________________________________________________
Telephone________________________________________________________________
Passenger name__________________________________________________________
Motorcycle make, Model, Year_______________________________________________
e-mail address_____________________________________________________________
Previous White Stag rider Yes_______ No_______
Entry Fee is still only $75.00 per person. Entry fee includes the Banquet-Awards ceremony, a premium quality long sleeve T-shirt and a bunch of fun.
Please send
check or money order payable to TOM ALMASSY
I have enclosed $75. ea x _____ for a total of $__________
Indicate shirt size and quantity (Medium thru 3X) ------------------------------------------------
I am participating in the WHITE STAG RALLY voluntarily, and agree to hold no one but myself accountable for any damages, losses, injuries, or death which may arise as a result of participation in this event.
Your signature of acceptance (required) _________________________________________
HAVE YOU MADE YOUR ROOM RESERVATIONS? 775-553-2419 THE STAGECOACH HOTEL-CASINO
Please note: your entry is not confirmed until we receive this signed application along with your entry fee.
Deadline for registration is Saturday Jan 19, 2008
Please print this form and mail it along with
your entry fee. Be sure to sign it and include your shirt size.