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Registration

ENTRY FEES :

Pre Register Via the PayPal Link above $10.00
Rally Day $15.00

A portion of these proceeds will go to the Floyd humane Society to help our furry friends.

Registration Information:
Pre-Register via PayPal and save $5.00 and receive Free Gift Bag full of goodies.
Pre-Registration ends Oct. 5th, 2011.
Pre-Register by mail or PayPal.
BRSC P.O. Box 20106, Roanoke, VA 24018
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Vehicle: Make / Model / Year
Club Affiliation:
Comments:



 

 

 

 

 

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