Rekluse Mississippi River Championship Series

Registration Form

First Name:                                            Last Name:

Address:

City:                                                        State:                                  ZIP:

Phone:

Email:

Bike Brand:                                                    CC:

Bike Model:                                                   Model Year:

Jacket Size:   medium      large       XL       2X

Class:              AA                   (circle appropriate class and riding level)

                        A                                 0-Open           Vet +30          Senior +40

                        B         0-200              201-Open       Vet +30          Senior +40

                        C         0-200              201-Open

                                    Super Senior +50

                        Mini    50cc                65cc 7-11      85cc 12-15