POKER RUN for MAKE-A-WISH FOUNDATION
2704 IITH STREET ROCK ISLAND, IL 61201
(309) 793-0375 FAX: (309) 793-1379
E-MAIL: SALES@WAKEENS.COM
(One person per application)
NAME :____________________________________________________
ADDRESS :__________________________________________________
CITY :______________________________________________________
STATE:_______________________________________________
PHONE: ___________________________________________________
SHIRT SIZE:___________________________________________
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Please make checks payable to Wakeen's/Make a Wish. The cost is $25.00 per poker hand.
Any donation is welcome!! remember this is for the Make A Wish Foundation
POKER RUN WAIVER AND RELEASE:
I know that this event is a potentially hazardous activity and I hereby assume full and complete responsibility for any accident or injury during my participation. I hereby release, hold harmless, and covenant not to file suit against the event sponsors.
WE PROMOTE SAFE BOATING
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