Game Date

Passenger Name(s)

Street Address

City, State, Zip

Home Phone (Numbers only - no dashes or spaces please)

Mobile Phone (Numbers only - no dashes or spaces please)

Please be sure this is the mobile number you will have the day of the game in the event we need to contact you!

Email Address

# of Seats

Comments:

Have you riden on the Skinsbus™ before?

Yes No

Method of Payment?

You may pay via Paypal, Cash or Check. If you pay via Paypal, please add $3 fee per person. Cash or check is accepted the day of the game with a prior reservation.

If you cancel within 72 hours of gametime you are responsible for paying for your seats on the bus.

Any questions, please contact Mike at 703.622.6875.

PRICE: $60 per person ($63 per person if using Paypal)

Paypal $63 person (click here) (Add $3 per person for paypal payments) Email payment to: mkopp67@yahoo.com.

Cash

Check - this is the preferred method of payment - Payable to Mike or Michelle Kopp.

* Remember to submit reservation form after processing paypal payment.

Disclaimer: The Skinsbus™ is family friendly; please respect other passengers on the bus. Beer is available to anyone over the age of 21 - if drinking alcohol, please be responsible and do not drink and drive. We will not be held liable for any damages resulting from the chartering of this bus or organization of this event. We are merely organizers of these events, we are not agents of the bus company and the bus company is not our agent. By riding on the bus, you are expressly waiving your right to sue us.

Please check this box to agree with the disclaimer.