Registration Form

The only information that will show up on the Riders list is your Name, Internet Name, Internet Group, Motorcycle info, City, State, Miles and when you plan on Arriving. All other information is only used to keep Terry busy calculating whacky stats. You can calculate your miles by visiting the Map page first. This is a free event and registering only helps with the planning. You can donate by going to the Donation page, if you would like. Registration will stop on Wed April 7, 2010 at 6:00 PM, but you can still come. This just gives us an idea of the numbers and Terry's wacky facts.

* Required Fields

First Name: *

Last Name: *

Are you a pillion rider (or sidecar)?

Email Address: *

Verify Email Address: *

Internet Name (If you have one):

Internet Group (If you belong to one, e.g., ST-Owners):

Motorcycle Make (If you own more than one, select primary): *

Motorcycle Model: *

City: *

State: *

How many miles to Moonshine oneway? (Please no tenths): *

What day do you plan on arriving to Moonshine? *

Are you planning on attending Thursday night cookout?

Are you planning on attending Friday lunch?

Are you planning on attending Friday dinner?

Are you planning on attending Saturday dinner?

Are you planning on attending Sunday breakfast?

This is just for survey purposes. If you plan to purchase a T-shirt(s), please fill out sizes and quantities needed.

Small:

Medium:

Large:

X-Large:

XX-Large:

XXX-Large:

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