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Hospice
Harley Davidson

Frank Kimler Poker Run Online Pre-Registration

Proceeds To Benefit
American Cancer Society Pancreatic Research Fund
Hospice of Orange and Sullivan Counties, Inc – The Frank Kimler Legacy Program
Shawangunk Correctional Employee Benefit Fund

$25 DONATION PER PERSON
All are welcome to Chicken Bake
Live Music - Beer - Wine - Soda - Prize Raffles
Free T-Shirt for All Pre-Registered

Name:
  Rider Non-Rider
Number Attending Chicken Bake:
Address:
City, State, Zip:
Phone:
E-Mail:
  
Shirt Size:   Num of Shirts:  
Shirt Size:   Num of Shirts:  
Shirt Size:   Num of Shirts:  
Shirt Size:   Num of Shirts:  
 
  

CHECKS PAYABLE TO: “Deanne Kimler” (Write: “Poker Run” on Memo Line)
Mail to: 1334 Route 52, Walden, NY 12586

Check must be received by Deanne Kimler by Wednesday, August 20th, 2008.

Downloadable pre-registration form also available by clicking here.