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NAME
__________________________________________ HOME
PHONE __________________
ADDRESS _______________________________________
WORK PHONE __________________
CITY _______________________________________
STATE ___________ ZIP ____________
E-MAIL ____________________________________________________________________
~ REGISTRATION ~
ADMISSION. Advanced Registraton: $35.00 each.
Advanced registration must be postmarked by
5/31/07. HOW MANY? _______
$40.00 each after May 31, 2007.
LAKE OF THE WOODS ADVENTURE TOUR, includes numbered cast belt
buckle, patch, certificate, map, T-Shirt, chance to win motorcycle
trailer..
~ EMERGENCY CONTACT INFORMATION ~
NAME _______________________________________
PHONE ___________________________
MOTORCYCLE BRAND, YEAR, COLOR _________________________________________________
MOTORCYCLE REGISTERED IN WHAT STATE _________ LICENSE
#________________________
BRAND & LICENSE OF CAR, TRUCK, or RV
_____________________________________________
FROM WHAT SOURCE DID YOU HEAR ABOUT WOLF'S HEAD MOTORCYCLE
RALLY & TOUR ?
Magazine, which one _________________________ Club, which one
__________________________
Advertisement/Website, which one ____________________ Friend or other
source________________
Please make check payable and mail to: Lake Basin Promotion, Dept WF,
Box 9, Carlton MN 55718
For credit cards (no American Express), include card type, number, exp date, amount to be charged, and
signature.
Card type ________ Card number ____________________________ Exp date _________
Amount ____________ Signature
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