BRAVE
Riders – Ride To Remember

Sunday
June 24, 2007

Rain or Shine

2007 Web - Printable Pre-Registration Form

Mail completed form with check
or money order made payable to

“BRAVE Riders" Before
May 27 2007 to:

BRAVE Riders

Post Office Box 393

Aliquippa PA 15001

One Pre-Registration Form per Vehicle - Please Check All That Apply

□ Motorcycle      □ Classic Car       □ First Year            □ New Address

Name:

Pre-Registration – Rider                                 $15.00

(Includes 1 meal tic.)

Address:

Pre-Registration – Passenger                        $15.00

(Includes 1 meal tic.)

Passenger
Name:

Classic Car - Per Vehicle                               $15.00

(Includes 1 meal tic.)

Address:

Email
Address:

Total
Registration:              @ $15.00 =    $

Total
Sponsorship:                                    $

I
/ we will ride "In Memory Of”

If Total
Sponsorship is $100 or more, no registration fee is needed! (Only one
free T-shirt & Patch or Dash Plaque and Meal Ticket per entry)

Department

Total
Amount of Remittance:                    $

I /
We, the undersigned, release from liability BRAVE Riders, committee members,
it's staff and volunteers, any and all benefactors and or beneficiaries, the
officers and members and any other parties or municipalities assisting us,
either directly or indirectly.
Moreover, hold harmless and free from any liability resulting from my
/ our participation in this event.
Being of sound mind and capable of behaving in a responsible manner, I
/ we accept full responsibility for any consequences resulting thereof.

Telephone
Number:

Signed:

SPONSORS

Bonus Offer!  Raise $100 or more in donations and
receive commemorative items. (Dash Plaque for Classic Car Reg)
and ride FREE!!  Simply add
the name and address of each sponsor in the area provided and return by mail
by May 27, 2007

Name:

Amount

Name:

Amount

Address:

Address:

Name:

Amount

Name:

Amount

Address:

Address:

Name:

Amount

Name:

Amount

Address:

Address:

Name:

Amount

Name:

Amount

Address:

Address:

Name:

Amount

Name:

Amount

Address:

Address: