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 - $25.00 each $
Non-Member Guests pre-registering - $25.00 each $
ADDITIONAL ITEMS
Children Under 16 FREE
Special Events
Chicagoland Speedway - Track Ride and Tour on Friday, June 8 (only available during Pre-Registration limited to 1st 600 people, $5 PP, must be 18 years or older, SHINE Only Event-No Refunds). (If event is cancelled those that registered for event will be issued a commemorative track package). - $5.00 each $
Rally Program
Be part of history by adding your name to the 2012 Rally Program that will be distributed to each registered attendee. $1 per person. Your name will be listed under your H.O.G. Chapter if they purchase a spot in the program. Otherwise, all supporters will be listed alphabetically. - $1.00 each $
Men's T-shirt:
Small - $15.00 each $
Medium - $15.00 each $
Large - $15.00 each $
XL - $15.00 each $
2XL - $15.00 each $
3XL - $15.00 each $
Women's T-shirt:
Small - $15.00 each $
Medium - $15.00 each $
Large - $15.00 each $
XL - $15.00 each $
2XL - $15.00 each $
Men's 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 $
Men's Hooded Sweatshirt:
Small - $30.00 each $
Medium - $30.00 each $
Large - $30.00 each $
XL - $30.00 each $
2XL - $30.00 each $
3XL - $30.00 each $
Rally Pin - $5.00 each $
Rally Patch - $5.00 each $
Rally Cap - $15.00 each $

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.