Please follow these instructions to print and send in your form:

DO NOT PRINT THIS PAGE - submitting this page will not register you for the event.

  1. Complete the registration form to the end, filling out all required fields
  2. You may choose to register another H.O.G. Member or Non-Member Guest by clicking the appropriate button after the first H.O.G. member information.
  3. Push "CREATE FORM"
  4. Wait for your Print Window to pop up THEN you can hit PRINT
  5. The mailing address appears on a COMPLETED form which you printed. Mail form and check to the address listed

PRICES INCLUDE ALL APPLICABLE TAXES.
REGISTRATIONS ARE NON REFUNDABLE AND NON TRANSFERABLE.
FIRST H.O.G. MEMBER INFORMATION
* Required Fields
H.O.G. Member
*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
*Country:
*Phone:
Please format phone# like this: xxx-xxx-xxxx
Email:
*National H.O.G. number:
H.O.G. number is two letters followed by seven digits.
For example, US1234567
*Expiration Date:
Local H.O.G. Chapter:
(Optional)
If you'd like to register an additional H.O.G. Member or Non-Member Guest, please choose one of the options below and fill out the appropriate information.

       
REGISTRATION SUMMARY
Prices include all applicable taxes.
H.O.G. Members pre-registering - $30.00 each
(Pin included; t-shirt not included) 		$
Non-Member Guests pre-registering - $30.00 each
(No t-shirt) 		$
ADDITIONAL ITEMS
Children Under 15 FREE
Long-Sleeve T-shirt:
Small - $20.00 each $
Medium - $20.00 each $
Large - $20.00 each $
XL - $20.00 each $
2XL - $20.00 each $
3XL - $20.00 each $
Henley T-shirt:
Small - $20.00 each $
Medium - $20.00 each $
Large - $20.00 each $
XL - $20.00 each $
2XL - $20.00 each $
3XL - $20.00 each $
Extra State Rally Pin - $8.00 each $
Bandanna - $10.00 each $
Rally Cap - $15.00 each $
New Custom Full-Color Patch - $9.00 each $
Travel Mug - $10.00 each $
Exclusive Kansas Package Rides
Package ride prices are per person. All package rides include meal.
Guided scenic ride to Canadian, Texas - Friday: - $17.50 $
Guided scenic ride to Canadian, Texas - Saturday: - $17.50 $
Guided ride to historic Boot Hill, Dodge City - Friday: - $30.00 $
Guided ride to historic Boot Hill, Dodge City - Saturday: - $30.00 $
Guided ride to new casino in Dodge City - Friday: - $20.00 $
Guided ride to new casino in Dodge City - Saturday: - $20.00 $
Total Amount Due
(Includes all applicable taxes)		 $ 
To complete your registration, click the Create Form button. Print and mail the resulting form. DO NOT PRINT THIS PAGE.