HiddenDate MM slash DD slash YYYY Name(Required) First Last PhoneEmail RegistrationRegistration Fee Price: ExtrasAdditional Riders (Includes Poker Hand)No Extra+1 Rider - $20.00+2 Riders -$40.00+3 Riders - $60.00+4 Riders - $80.00Additional Poker HandsNo Extra+1 Hand - $20.00+2 Hands - $40.00Total Credit CardCard Details Cardholder Name