SOUTHERN TIER TANDEM RALLY - STTR 2008

SOUTHERN TIER TANDEM RALLY
850 W. Clinton St. 
Elmira, NY 14905
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For three days: 
Fri. August 22nd to Sun. August 24th - $65 per Tandem   Number Bikes: ___ Total: $________
Or for one day:
Sunday August 24th only - $30 per Tandem          Number Bikes: ____ Total: $___________

(After July 1st add $10 per Bike)



Total Registration (Please make checks payable to "STTR")...............$___________ 
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Participant Info:    Captain                                  Stoker

Name: __________________________________      Name: ________________________________

Address: _______________________________      Address: (If Different) ______________

________________________________________      ______________________________________

City: __________________________________      City: ________________________________

State: ________ Zip Code: ______________      State: ________ Zip Code: ____________

Phone: _________________________________      Phone: _______________________________

E-Mail: ________________________________      E-Mail: ______________________________

Emergency Contact:                            Emergency Contact:

Name: __________________________________      Name: ________________________________

Relationship: __________________________      Relationship: ________________________

Phone: _________________________________      Phone: _______________________________

MINORS: Names, Ages, Relationship: _________________________________________________

MINORS: Names, Ages, Relationship: _________________________________________________

Tandem make: __________________________ Model: _______________________  Year: ______