OPOG Poker Run Early Registration at The Rocking Horse Smokehouse Hartford Turnpike Vernon, CT
Date: September 1st, 2024 Registration: 10am Kickstands up: 11am
Name
First Name
Middle Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Contact Number
Are you a Veteran (Let us celebrate you)
Yes
No
In Case of Emergency
Emergency Contact:
First Name
Last Name
Relationship
Contact Number
Release and Waiver of Liability, Route Map w/stops and Game Cards will be supplied day of.
My Products
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Rider Early Registration
Prizes for top two hands and worse hand. Any Royal Flush wins 2024 Street Glide
$
40.00
Food Vouchers
No
Yes
Passenger Registration
Prizes for top two hands.
$
15.00
Food Vouchers
No
Yes
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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