AMERICAN TRIKE ASSOCIATION

ATA Registration 2008

PRE-REGISTRATION DEADLINE IS JULY 1, 2008 Return This Form With Payment to: ATA Secretary: Mary Ann Parish 3201 Barbell Court Cheyenne, WY 82001 (307) 637-4105 trikerchik@aol.com	ATA Rally Dates –July 31, Aug 1st & 2nd 2008 Buffalo, Wyoming Indian Campground Pre-Registration Information Required Per Attendee: MEMBER #____________ NAME_________________________________________________ ADDRESS______________________________________________ CITY, STATE ZIP_____________________________________________ Telephone_______________________Cell#____________________________ E-MAIL_________________________________________________________ Emergency Info: (Medical Decision Maker in Case of Emergency) Name_______________________________Relationship__________________ Address__________________________________________________________ Telephone #’s_____________________________________________________ Secondary Contact Name___________________________________________ Address__________________________________________________________ Telephone #’s_____________________________________________________ Special Medical Information (allergies etc.)____________________________
Additional Contacts	Registration Fees
Karen Hendricks, President (303) 421-7354 Tom Parish, Vice-President thomas.d.parish@sprint.com Indian Campground Registration (307) 684-9601 e-mail address: indianc@trip.com Buffalo Chamber of Commerce (800) 227-5122 e-mail: buffalochamber@wyoming.com Web Site for Accommodations buffalowyo.com	Members Non-Members New Membership $10 ________ Renewal Membership $10 ________ Rally Fee $5 ________ Rally $10 _________ Banquet $10 ________ Banquet $12 _________ Cookout Free ________ Cookout $7 __________ Poker Run – Per Hand $5 ________ Poker Run $5 _________ Trike Games Included in Rally Fee, Please Circle the Appropriate Items I will be Participating in Trike Games YES / NO Passenger / Driver