Registration Page

Riders Registration Form

Please fill out the information below, then be sure to click on the Submit button.

  Then chose your registration option below this form and click on the
"Proceed To Payment" button.
You will be taken to a secure page to complete your registration.
You will be sent a confirmation receipt to the e-mail address entered on payment page.

Thank You for caring to share and being part of this great cause.

* Requited fields

First Name: *
Last Name: *
 Check one *
I'm registering for one rider                                                  $10
  I'm registering for one rider & one back seat rider             $15
  I'm registering for two solo riders                                        $20
  I'm registering for two riders, & one back seat rider          $25
  I'm registering for two riders, and two back seat rider      $30
   
 CHECK ONE *
 WESTERN SPOKE CHECK POINT REST STOPS
   Start: 1st Registration Check Point/Rest Stop, VFW Post 2420, Lake Wales, FL
   2nd  Registration Check Point/Rest Stop, Moose Lodge 2083 Davenport/Haines City
   3rd Registration Check Point/Rest Stop, VFW Post 4225, Kissimmee
   4th Registration Check Point/Rest Stop, American Legion Post 80 St. Cloud
   5th Registration Check Point/Rest Stop, Lone Cabbage Fish Camp West Cocoa
   
   NORTHER SPOKE REGISTRATION CHECK POINTS/REST STOPS
   Start: 1ST Registration Check Point, Iron Horse Saloon, Ormond Beach, FL
   2nd Registration check Point/Rest Stop, American Legion Post 270, Port Orange
   3rd Registration Check Point/Rest Stop VFW Post 4250 New Smyrna Beach
   4th Registration Check Point/Rest Stop VFW Post 4228 Titusville
   
   MERGE POINT OF NORTHERN & WESTERN SPOKES
   Merge Point Registration Check Point/Rest Stop Moose Lodge 1717 Cocoa
   
   FINISH/END IF YOU CAN'T MAKE IT TO ANY CHECK POINTS & STILL WANT TO SUPPORT REGINA BONNEY
   Finish/End H & D Roadhouse S.R. 520 Merritt Island
   
Address Street*
City: *
Zip Code: * (5 digits)
State: *
Phone: *
Email:
   
   Thank You for your support.
   
Comments
& Questions

Please select the your choice of registration options on the drop down menu below,
 then click on the "Proceed to Payment" button.


Choose a registration option
Advance Registration Rider Prices