RALLY IN THE VALLEY 2004 Registration Form
Registration Fee - $25.00
Reg. Fee covers: Trophies, Banquet Room, Door Prizes, Car Show and Rally.
Registration forms must be postmarked no later than June 23 2004.
Rally in the Valley Activities (check the boxes you plan to attend).
Friday Night, July 23rd
_____ Friday Night Cruise around the Lake. (Included in Reg. Fee)
_____ Sea Food Buffet - $10.95 @ Paradise Shores (Pay your server)
Saturday Morning, July 24th
_____ Breakfast- 7:00am-8:30am -$5.00 at Paradise Shores (Pay server)
Al Capone’s Hide Out Tour & Bootleg Rally:
_____ Tour = $11.00 per person x Qty ____ Tour = $_______
(Lunch Menu Choices) Cost includes beverage, tax and tip.
“The Enforcer” (Hamburger) $12.50 x Qty_____ Food = $_______
“Prime Sandwich” (Prime Rib Sand.) $13.00 x Qty____
“Chicken Fillet” (Grilled Chicken Breast Sand.) $11.75 x Qty____
Al Capone’s Total: = $_______
Saturday Afternoon, July 24th
_____ Show n’ Shine Car Show. (Included in Reg. Fee)
Car Entered_______________________________ Year_______
_____ Funkhana. (Included in Reg. Fee)
Water Balloon Toss, Brake Discus Throw & Wheel Cylinder Shot-put.
Saturday Night, July 24th
_____ Banquet - $15.00 per person x Qty____ Banquet Total: = $_______
Rally in the Valley (T- Shirt) or (Sleeveless T-Shirt):
T-Shirt (Circle size ) Sleeveless T-Shirt (Circle size )
Men’s Size: S M L XL XXL Men’s Size: S M L XL XXL
$12.00 ea / (2X) $14.00 ea $10.00 ea / (2X ) $12.00 ea
Women’s Size: S M L XL XXL Women’s Size: S M L XL —
$10.00 ea / (2X) $12.00 ea $10.00 ea / (No 2X Available)
Shirt Total: = $_______
Registration Fee: Reg $ 25.00
EVENT TOTAL $_______
Phone: Best time to call? _(______)________________________
Make check payable to: Diane Rindt -- Send to:
4271 N.Shore Drive, Eau Claire WI 54703
For more information contact
Steve & Diane Rindt - email@example.com - 715-832-8316