State Zip

Phone

Rider Name

Street  Address

City

Country

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Date

Date

Signature

Signature  of  Parent(If  participant  is  a  minor)*  Mail  completed, signed  forms  and  payment  to: Stumpjumpers  MC

30535 NE 132nd St Duvall, WA 98019

*   Payment   must   be   sent   with   pre-registration  form. **US CURRENCY ONLY***  Make  checks  or  money  orders  payable  to  Stumpjumpers  Motorcycle  Club.  Do  not  send  cash.*  Pre-registration  forms  must  be  received  by  March  30th,  2020.    Incomplete  or  late  forms  will  not  be  processed.  

Select  One

THIS  IS  A  RELEASE  AND  INDEMNITY  AGREEMENT  READ  BEFORE  SIGNINGI  hereby  give  up  all  my  rights  to  sue  or  make  claim  whatsoever  against  the  Stumpjumpers  Motorcycle  Club,  the  promoters,  sponsors,  landowners,and  all  other  person  or  organizations  conducting  or  connected  with  this  event  for  any  injury  to  property  or  person  I  may  suffer,  including  crippling  injury  or  death,  whether  such  injury  arises  while  I  am  preparing  or  participating  in  the  event  or  while  I  am  upon  the  event  premises.    I  know  the  risks  of  danger  to  myself  and  my  property  while  participating  in  the  event  and  while  upon  the  event  premises  and,  relying  upon  my  own  judgement  and  ability  assume  all  such  risks  of  loss  and  hereby  agree  to  reimburse  all  costs  to  those  persons  or  organizations  connected  with  this  event  for  damages  incurred  as  a  result  of  any  injury  I  cause  or  receive.

Iron Man Poker Run - Entry Fee: $40

Family Poker Run - Entry Fee: $30

Dual Sport Poker Run - Entry Fee: $45

*All poker runs include a t-shirt and free hotdog lunch while supplies last

*Free lunch at the Rocky Coulee Brewery for the first 100 dual sport poker run entries

2020 Desert 100 Saturday Poker Run Pre-registration Form

4530

March 29, 2020 May 16-17, 2020

And SalvageSprint Enduro!

March 28, 2020

**Dual Sport Lunch Sponsored by I-90 Motorsports**

**MOTORCYCLES ONLY****NO ATV OR SXS ALLOWED**