A Night With the Supercross Stars 3rd Annual Benefit

Action Sports Medicine Foundation

“A Night with the Supercross Stars”

Friday March 18, 2011 in Jacksonville, Florida

Ruth’s Chris Steak House Jacksonville Riverfront

7:30 pm







Please come join The Action Sports Medicine Foundation crew for a great dinner and a chance to mingle with some of the best Supercross racers in the world at the Third Annual “Night with the Supercross Stars” benefit dinner and auction presented by ASMF. This is an opportunity to get to know the host racers on a more personal level – ask a burning question or get a photograph with and autograph from one of these phenomenal athletes. This unique dining experience is hosted by The Action Sports Medicine Foundation, which raises funds and awareness for the on-site sports medicine program that it provides at numerous action sports events nationally throughout the year.



As a guest for the evening you will enjoy a fantastic dining experience at the amazing Ruth’s Chris Steak House on the Jacksonville Riverfront. You will have the opportunity to bid on great silent auction items and to bid live on jerseys to be personalized by the attending riders! There is also a special opportunity to go on a exclusive track walk on Friday afternoon!













Through your participation, you will have the honor and privilege of providing support for all of the athletes and families that are touched by the on-site sports medicine services that ASMF provides free of charge. You will enjoy the prestige and good will associated with raising awareness and funds for the Action Sports Medicine Foundations much needed programs for the future. Please help support the program that supports the Supercross and Motocross athletes of tomorrow.



Registration Agreement for:

Action Sports Medicine Foundation

“A Night with the Supercross Stars”



Guest Level of Participation:

Gold level – dinner only:

[ ] Individual: $150

[ ] Table of eight: $1,100



Platinum level – includes for each guest: dinner, Supercross club level tickets with Pit Passes, swag bag

[ ] Package of four: $800

[ ] Table of eight: $1400



Only 1 package of each available…get yours now!



Diamond level- includes for each guest: dinner, VIP tickets for Jacksonville Supercross, swag bag

[ ] Package of four: $1000



Only 2 packages available…call Christine today!!



I would like to add a track walk on Friday afternoon for $20:

Number of guests__________ @ $20 each





Tickets must be purchased by March 11, 2011.



Total amount enclosed: $____________



Contact Name: _____________________________________________



Billing Address: _____________________________________________

__________________________________________________________



Email: ____________________________________________________



Phone: __________________________ Fax: _____________________



Signature: _______________________________ Date: _____________



Please mail form & check to:

Action Sports Medicine Foundation

4624 Gerber Court

Jacksonville, FL 32210

or

to pay by credit card (Visa, Mastercard, or Discover)

Contact:

Christine Chmielewski: (904) 899-3366 christine@asmfjax.com



501c(3) Tax deductible ID # 57-1160023



Night events include: Dinner, Live Auction, Silent Auction, Photograph session, Cash Bar, Live music with Down Theory