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Registration form

PRINT FULL NAME
MAILING ADDRESS
CITY:
STATE:
ZIP:
HOME PHONE:
CELL PHONE:
E-MAIL
SINGLE RIDER REGISTRATION $20.00
RIDER W/ PASSENGER REGISTRATION $25.00
EXTRA DICE HAND
PHONE NUMBER
CHOOSE THE TIME GROUP YOU WOULD LIKE TO RIDE WITH
  

PAY PAL COMING SOON

IF REGISTERING BY MAIL FILL OUT FORM AND PRINT
 
MAKE CHECKS PAYABLE TO SHAWNEE KRUIZERS
 
MAIL TO;
KICKSTANDZ
411 W. BROADWAY
MCLOUD, OK. 74851
405-964-2111
 
OR REGISTER IN PERSON AT
 
KICKSTANDZ
411 W. BROADWAY
MCLOUD, OK. 74851
405-964-2111
OPEN 6 DAYS A WEEK
10:00AM-6:00PM
CLOSED WEDNESDAY