BORREGO SPRINGS NATIONAL ROAD RUN

HOSTED BY THE SOCAL CHAPTER

February 27th through March 2nd, 2003

Thursday—Sunday

Riders Name:________________________________________

Passenger’s Name_____________________________________

Riders Address:_______________________________________

City:__________________________ State:_____ Zip:________

Current AMCA Membership Number: ____________________

AMCA Chapter Name:_________________________________

Year/Make/Model of MC:______________________________

Insurance Company/Policy #:____________________________

Note: All Motorcycles MUST be 1968 or older for this Road Run

Cost: $90.00 per registered rider $ _______________

Includes T-Shirt, Banquet, Saturday lunch, Continental breakfast, and daily hospitality refreshments.

Specify Riders Tee Shirt Size S ___ M ___ L ___ XL ___ 2X___

Extra lunch for passenger ___ x $8.00 = $ _______________

Extra Banquet Dinners ___ x $30.00 = $ _______________

Extra Commemorative Short Sleeve Tee Shirt Pre-Order Only

S ___ M ___ L ___ XL ___ 2X ___ x $10 = $ ____________

Extra Commemorative Long Sleeve Henley Shirt Pre-Order Only

M___ L___ XL___ 2X ___ x $20 = $ ____________

Total Payment Enclosed $ _____________

Full Payment Must be Received by February 1st, 2003

Mail To: SoCal Chapter AMCA, 2058 Aliso Avenue, Costa Mesa, CA 92627

Phone: (949) 642-9682 — Email: socalamc@pacbell.net — http://www.socalamca.org