Eitzen Lions  --  Rivers & Bluff's Classic Tractors LLC Ride
Starting & Ending at Eitzen MN, Fire Station
Saturday July 1, 2017

Name: _________________________   Telephone: ________________   Cell: ________________
Address: ___________________________
City: __________________   State: _______   Zip: ___________   Email: _____________________
Emergency Contact: ________________________   Phone #: _________________
Tractor Information:   Year: _________   Make: _______________   Model: _________________
Desired Traveling Speed:   10-12 MPH _____   15 MPH _____  (All tractors must go 10 MPH minimum)
 

In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors, administrators, waive any and all rights and claims for damage I may have against individuals associated with this event, its agencies, representatives, successors and assigns, for any and all injuries suffered by me in said event. I attest and verify that I have full knowledge of the risks involved in this event and am physically able and sufficiently trained to participate in this event. I understand the Rivers & Bluff's Classic Tractors LLC committee reserves the right to limit the number of tractors involved in this ride. The Rivers & Bluff's Classic Tractors LLC committee reserves the right to refuse a participant entry into this event if committee desires to do so.

Signature of Driver: ___________________________________   Date: ___________________

You must have a Drivers License and must present it upon registration the day of the ride. You will be required to sign a drivers safety pledge.  Click HERE for the Driver's Safety Pledge

Pre-registration is appreciated. Sign up will be 7:30 am. Ride starts at 8:00 am. Be on time!

Fee for rides will be $20.00 per tractor / extra riders $10.00. Make checks payable to Eitzen Lions.

Total Enclosed:  $__________

Please return to:
Greg Mohwinkle
2971 Fox Farm Rd.
New Albin, IA  52160
Greg's Home#:  1.563.497.3691
Greg's Cell#:  1.563.217.0122