Las VegaLas Vegas Smokeout Registration

Please Identify Yourself

How many Registrations

($60.00 before 01/01/2027) * Required
Events in red (below) are included in the Registration Fee.

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	First Name	Last Name
Please enter each Attendee's Name in the table below ... * Required
#1	First Name #1 Required	Last Name #1 Required
	First Name #2 Required	Last Name #2 Required
	First Name #3 Required	Last Name #3 Required
	First Name #4 Required	Last Name #4 Required

Address

* Required Address Required

City

* Required City Required

State

Zip Code

Country

Phone No

* Required Phone No Required

How Many Years Have You been Attending Smokeout ?

Please indicate if you plan to attend these events:

Thursday, April 15th

Welcome Cocktail Party (Thur)
(Admittance charge covered by registration fee.)

Saturday, April 17th

Motorcycle Ride with Desert Brotherhood M.C. (Sat)
(MC Ride entry fee and lunch included in registration fee.)

SMOKEOUT® 2027 Commemorative T-Shirts Note: There will be no tshirts for sale at the event. All tshirts must be ordered and paid for online on or before March 28, 2027. Use this form for pickup at the event. If you want to have a tshirt mailed to you please use the "Order T-Shirts" menu button.
	Enter Quantity Size: Medium $30.00 Size: Large $30.00 Size: X-Large $35.00 Size: 2X-Large $35.00 Size: 3X-Large $40.00 Size: 4X-Large $40.00 Size: 5X-Large $45.00
You may use the following box to include any special instructions or comments. (optional)

You may pay your Registration Fee (on or before March 29th) online via a Credit Card or Paypal account. If you cancel this step your registration will be dropped.

When you click "Register" you will be transferred to our payment processor, Paypal. This may take a few seconds. Please do not refresh your screen.

Please Identify Yourself

Please indicate if you plan to attend these events:

SMOKEOUT® 2027 Commemorative T-Shirts