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"Thank you for visiting our motorcycle dealership. Please take time to review our services. If we can help you with anything please do not hesitate to contact us."

POKER RUN
May 8th

Rally Reservations

When you are ready to make your reservation fill out the form below and submit to Chrome Horse. Reservations are valid only when Chrome Horse has e-mailed you a confirmation. Please use our contact us page for general questions.

Insurance included in all rally rates

Daytona Bike Week 1-2 Days______________ $200 per day Daytona Bike Week 3 or More Days_________ $175 per day Panama City Spring Rally 1-2 Days_________ $175 per day Panama City Spring Rally 3 or More Days____ $150 per day Myrtle Beach Spring Rally 1-2 Days_________ $225 per day Myrtle Beach Spring Rally 3 or More Days____ $200 per day Laconia Motorcycle Week ________________ $185 per day Sturgis Motorcycle Rally Day Rides_________ $175 Sturgis Motorcycle Rally 1-2 Days__________ $250 per day Sturgis Motorcycle Rally 3-4 Days__________ $240 per day Sturgis Motorcycle Rally 5 or more Days_____ $230 per day Biketoberfest 1-2 Days___________________ $200 per day Biketoberfest 3 or More Days______________ $175 per day

First Name
Last Name
Address
City
State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
Country
Home Phone
Work Phone
Cell Phone
Fax
E-mail
Drivers License Number
License Expiration Date
Licensed State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Date of Birth
Requested Model (1st choice)	Road King Fat Boy Dyna Wide Glide Heritage Softail Classic Softail Deuce Road King Custom V-Rod
Requested Model (2nd choice)	Road King Fat Boy Dyna Wide Glide Heritage Softail Classic Softail Deuce Road King Custom V-Rod
Total Number of Bikes	1 2 3 4 5 6 7 8 9 10 10 + bikes please call.
Pick-Up Date	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Pick-Up Time	9:00am 10:00am 11:00am 12:00pm 1:00pm 2:00pm 3:00pm 4:00pm 5:00pm 6:00pm
Drop Off Date	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Drop Off Time	9:00am 10:00am 11:00am 12:00pm 1:00pm 2:00pm 3:00pm 4:00pm 5:00pm 6:00pm
Credit Card Number (we only accept Mastercard and Visa)
CVV Number (last 3 digits on back of card)
Expiration Date	January February March April May June July August September October November December 2009 2010 2011 2012 2013 2014 2015
Confirm Reservation by	Phone Email
Additional Information or questions

Yes, I hereby confirm that I have read and agree to the Terms and Conditions

Yes, I hereby agree to the non-refundable deposit to confirm this reservation.

All information is transferred via secure server.

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