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JOHN A. AYELLO FALLEN OFFICER MEMORIAL RALLY 2009

Event Registration

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John A. Ayello fallen officer memorial rally

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click here to download event flyer

START: 9:00 AM

Saterday, 29th August 2009

Hermy’s BMW

Rt 61 port Clinton, PA

ENTRY FEE: $35

Passenger $15

Walk-in $35

REGISTRATION is open

ENTRY FEES ARE NON-REFUNDABLE

FINISH: NO LATER THAN 7:30 PM that day

THE JOHN A. AYELLO RALLY IS A LONG-DISTANCE TOUR, NOT A RACE, AND WILL CHALLENGE

YOU TO COMPLETE A SCENIC ROUTE FEATURING MANY OF HAZELTON AREA BEST HIGH

COUNTRY BACKROADS AND MOUNTAIN PASSES.

 

THE  OFF-ROAD/ADVENTURE (G.S.) Gelande Strasse RIDING, QUALIFIED FINISHERS WILL RECEIVE A SPECIAL COMMEMORATIVE PPCA MEDALIAN IN RECOGNITION OF THEIR ACCOMPLISHMENT AND THE OPPORTUNITY TO REGISTER WITH THE RALLY.

 

LIMITED TO 200 ENTRIES.

ALL BIKES ARE WELCOME.

 

COMPLETE EVENT AND HOTEL INFORMATION WILL BE MAILED UPON RECEIPT OF YOUR ENTRY.

ROUTE INSTRUCTIONS AND GPS down-loads WILL BE PROVIDED AT CHECK-IN. A LIMITED NUMBER OF HOTEL ROOMS ARE BEING HELD FOR THE RALLY. SIGN UP EARLY TO ENSURE HOTEL AVAILABILITY.

 

This event is expected to sell out early, so sign up now!

2009 MEMORIAL RALLY ENTRY FORM

 

Name: _______________________________________________________________________________________

(Please print)

 

Address: _____________________________________________________________________________________

 

City: _________________________________________________________ ST: _________ Zip: _____________

 

Phone: (______)_______________________ T-Shirt: S M L XL XXL (Circle size)

 

E-mail:_________________________________________

 

Emergency Contact Name and Telephone: ________________________________________________________

 

Motorcycle: Make: _____________________________ Model: _____________________________ Yr: _________

 

Insurance Info: ___________________________ Name of Company:__________________________________

 

Drivers License Number:_________________________ License Plate Number:_______________ State:______

 

Male _ Female _ Driver _ Passenger _ If passenger, name of driver: _________________________________

 

Total amount enclosed: $_________________ 

 

Mail entry with check payable to PPCA. Mail to PPCA Rally C/O Susie Zeiner – 263 Fremont RD Nottingham, PA 19362

Terms: PA Police Canine Assoc (PPCA), Hermy’s BMW and Tire Company Inc, Rausch Creek Trailriders, it's Owners, associates, agents and companies shall not be held responsible for and shall accept no liability in respect of any claims, losses, damages, costs or expenses arising from personal injury, sickness , disease, accident or death incurred during any rally events, motorcycle tour, however caused, without limitations. Loss or damage to baggage, or other property caused by weather, equipment failure or any other causes will not be the responsibility of PPCA, Hermy’s BMW and Tire Company Inc, Rausch Creek trailriders.  We reserve the right to decline or refuse any person participation in our rally should they not conform to rally guidelines or terms. Waiver Agreement: I Understand and accept the terms, conditions and information contained herein. I hereby accept all risks of personal injury and property damage arising from my participation in this tour and I agree that myself, my dependents, heirs, executors do indemnify PPCA, Hermy’s BMW and Tire Company Inc, Rausch Creek Trailriders and its employees, owners, directors and representatives against any and all claims or costs. Further, by signing this form, I certify that if I am a licensed motorcycle operator and that I hold a currently valid, state issued motorcycle operator’s license. I understand that I will wear a helmet in the states where it is required by law, and when in states where helmet use is optional I understand the choice of wearing a helmet or not, is solely my own.

I have fully read and agree to abide with the Terms and Release of Liability as stated above.

Signature: ________________________________ Date: ________________

 

 

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Sponcered by * Pennsylvania Police Canine Assoc * Rausch Creek Trail Riders * Hermy's BMW and Tire Company *