Lazy Rider’s Prize Drawing Entry Form
First Name
Last Name
You are
Male
Female
Do you mostly
Ride Single
Carry Passenger
Rallies attended per year?
1-3
4-5
More than 5
Brand Motorcycle:
Choose Brand
Harley
Kawasaki
Honda
Suzuki
Other
Other:
Model:
Year:
Information needed to ship prizes, etc.
* optional info
Address
City
State
Zip Code
E-mail Address
Web Address
*
Telephone
FAX
*
May I email you new motorcycle related product information?
yes
no
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