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Rekluse Mississippi River Championship Series
Registration Form
First Name:__________________________ Last Name:____________________
Address: __________________________________________________________
City:_______________________ State:__________ ZIP: __________________
Phone: _______-_______-____________ Phone 2: _______-_______-__________
Email: _________________________@_________________________________
Bike Brand:________________________ Size: ______________________
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-Open Vet +30 Senior +40
C 0-Open
Super Senior +50
Mini 50cc 65cc 7-11 85cc 12-15
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