To the 2015 H4H Registration form.

Transcription

To the 2015 H4H Registration form.
Registration Form
16th
16th Annual
Annual
Entry Fee: $30 Single Rider / $50 Rider
With Passenger
Benefit
Motorcycle
Run
Entry Fee includes: Ride from LaPlace
Travel Center, lunch at Manny’s Bar in
Maurepas, and back to Fatty’s Main Street
Grill with entrance to the live music show.
Mail-in entries must be postmarked by
April 9, 2015.
For The
Please print:
Greater New Orleans
Therapeutic Riding Center
Name ______________________________
Mailing Address ______________________
City, State, Zip _______________________
Phone ______________________________
Email address ________________________
Name of Passenger (if applicable)
____________________________________
T-Shirt Size: S
M
L XL 2XL
Passenger T-Shirt Size: S M L XL 2XL
Mail this form to:
GNOTRC
P.O. Box 23284
New Orleans, LA 70183
A St. John United Way
Agency
A United Way
of St. Charles Agency
GNOTRC
✄
www.gnotrc.com
Email: [email protected]
Website Address:
CUT HERE
Pre-register by April 9, 2015 and
receive a FREE
2015 Harley For Horses T-Shirt
P.O. Box 23284
New Orleans, LA 70183
Sunday - April 19, 2015
Harley For Horses
Open To Riders Of All Makes of Motorcycles
Live Music by Sac-a-Lait
immediately following the Run
B
Benefit For The Greater New Orleans
Therapeutic Riding Center
J
oin us on April 19, 2015, for the Harley for
Horses Benefit Motorcycle Run to benefit the
Greater New Orleans Therapeutic Riding Center, a
nonprofit organization dedicated to the well-being
of children and adults with disabilities through horse
assisted activities. The organization was founded
in 1993 with four students and two horses. Today,
the riding center helps riders with disabilities with
nine horses.
The motorcycle run, open to riders of all makes
of motorcycles, began when GNOTRC was given a
pet pig named Harley, which has become the mascot
for this event.
This year’s motorcycle run is set to depart at
11:00 A.M. on April 19, 2015, from the LaPlace
Travel Center at 4325 Hwy. 51 in LaPlace. Registration will start at 9:00 A.M. The route will take the
run for lunch at Manny’s Bar, 19706 Highway 22
in Maurepas, and end at Fatty’s Main Street Grill
in LaPlace with live music, a raffle, and an auction
following the run.
Registration for the event is $30 for a single rider,
and $50 for rider and passenger. The fee includes
lunch at the midpoint, and admission to the live
music following the run. Music will start at 3:00
P.M. Non-riders are invited to join the festivities at
Fatty’s Main Street Grill for a small fee.
Once again this year’s Harley for Horses Benefit
Motorcycle Run will be dedicated to fallen St. John
Deputy Brandon Nielsen, who organized and also
escorted the ride over the last several years. Donations will be accepted for the families and survivors
of the Fallen Four.
For more information call GNOTRC at
504-466-9960 or 985-651-LADY
Website Address: www.gnotrc.com
Email: [email protected]
GNOTRC is a
nonprofit organization.
Nonprofit ID # 72-1234671
TIME: Registration
starts at 9:00 A.M.
Ride departs at 11:00 A.M.
LOCATION: Ride departs from the LaPlace
Travel Center at 4325 Hwy. 51 in LaPlace, stops
for lunch at Manny’s Bar in Maurepas, and ends
at Fatty’s Main Street Grill.
FEE: $30 for single rider, $50 for rider with passenger. Fee includes lunch and free admission to
the post run celebration. Those riders who preregister by April 9, 2015 will also receive a free
Harley For Horses 2015 T-Shirt.
y signing this application, the undersigned
herewith acknowledges that the Harley for
Horses benefit scheduled for the 19th day of
April, 2015, is a recreational event designed to
aid a charitable non-profit organization and is not
a race, challenge match or test of skill. Safety of
spectators and participants is a primary concern
of the organizers, sponsors, and others involved
in the presentation of this event. The undersigned
herewith agrees not to engage in racing or any other
unsafe activity in connection with the referenced
Ride. The undersigned, for consideration duly
acknowledged, herewith releases, holds harmless
and indemnifies Harley for Horses, LaPlace Travel
Center, Manny’s Bar in Maurepas, Fatty’s Main
Street Grill, and other locations, and any officers,
employees, volunteers, and associates thereof, as
well as any organizers, sponsors or beneficiaries
of the referenced event, from any and all liability
for damages that may be incurred by any person or
entity due to or as a result of the undersigned participation in the Harley for Horses ride scheduled
for April 19, 2015. I fully understand that the registration fee is not refundable and all proceeds will
go to the Greater New Orleans Therapeutic Riding
Center. Participants must be 21 years of age.
Signature
Signature of Passenger, if applicable
Manny’s
10% OFF
Make check payable to:
GNOTRC
Greater New Orleans
Therapeutic Riding Center
WITH THIS COUPON
from 9am-11am, 4-19-15 only.
Pre-register by April 9, 2015 and receive a free t-shirt!
Please check our website for info. Mail-in entries
must be postmarked by April 9, 2015.