Hi-Lo Poker Run

Registration Form
www.Hi-Lo-Poker-Run.com

Sponsored By:

KIWANIS CLUB of Gulf Shore Saturday – May 14, 2011

 

Poker Run by boat or car (THIS IS NOT A RACE!) – 10:00 A.M. to 4:00 P.M.

Dealing of Poker Hands begin at 4:30 P.M. at GUY HARVEY’S AT THE WHARF

Entry Fee: $200 Per Boat/Car (Receive 5 Certificates = 5 hands of poker)

$50 for each additional Certificate = 1 hand of poker

Holders of Certificates may buy additional poker hands for $25 each

Register before April 20, 2010 to qualify for Early Bird drawing

 

Name:                                                    Phone:                         Email:                                   

Address:                                                City:                            State:               Zip:               

 

Shirt Size for Captain’s Shirt: M __ L __ XL __ XXL __ Additional Shirts-$15.00 each

 

$250 per      BOAT      CAR     (circle one)  (Receive 5 Certificates)      $  200

Additional CERTIFICATES                                                 x  $50 each =                   

Additional hands (for existing Certificate holders)                x  $25 each =                     

Additional shirts M___L___XL___XXL___                      x  $15 each =                     

                                                            TOTAL AMOUNT ENCLOSED $
Two ways to pay:                                                                                       ========
1. Check payable to Kiwanis Club of Gulf Shores, or  

2. Charge my credit card and FAX TO (251)971-2682: 

Credit Card Type: Visa ___ MC___                       Name on Card: _____________________

 

Card Number: _________________________        Expiration Date: _______________

 

Signature: ____________________________

 

PLEASE READ AND SIGN:         I hereby release and agree to hold harmless Kiwanis Club of Gulf Shores, its members and contributing sponsors from all liability. I agree to assume all responsibility for my acts, the acts of my crew and the acts of my guests and agree to indemnify and hold Kiwanis Club of Gulf Shores, its members and its contributing sponsors harmless from any and all damages or expense resulting there from should any accident, injury or death occur.

 

Entry fees must be received in full by May 13, 2011 and are NON-REFUNDABLE. Entry fees may be transferred by you to another party of your choice at any time prior to the start of the Hi-Lo Poker Run. No rain checks. Must be present to win.

 

Captain’s Meeting to be held Friday, May 13, 2011 at Guy Harveys at The Wharf at 7:00 P.M.

 

Please return this page with check for NON-Refundable entry fee and payment for additional CERTIFICATES and additional poker hands to:

 

Kiwanis Club of Gulf Shores

P.O. Box 2601

Gulf Shores, AL 36547

 

I agree to participate in the Kiwanis Club of Gulf Shores Hi-Lo Poker Run under the terms and conditions outlined herein.

 

 

Signed: ____________________________________          Date:  ______________