POLAR BEAR RIDE
Patches, Pins & Rockers
Main patches ordered: _________ @ $ ______ = $ ____________ Teddy or Biker -  circle one
2012 Rockers ordered: _________ @ $ ______ = $ ____________  white or blue background - circle one
2011 Rockers ordered: _________ @ $ ______ = $ ____________  white or blue background - circle one         
2010 Rockers ordered: _________ @ $ ______ = $ ____________  white or blue background - circle one
2012 Pins ordered: ____________  @ $ ______ = $ ___________  
2011 Pins ordered: ____________  @ $ ______ = $ ___________   
2010 Pins ordered: ____________  @ $ ______ = $ ___________   
           
                                           
TOTAL     = $ ____________
Name: ___________________________________    Phone: __________________________
Address: __________________________________   Email: __________________________
City: _________________________   State:  _____     Zip: ___________________________
Send order form with credit card info, check or money order to:
Piper's Enterprises LLC
575 County Rd. 159
Westcliffe, CO  81252
                    For Visa, MasterCard or Discover payment:
Name on Card
(if different from above): _____________________________________
Address
(if different from above): __________________________________________
City:  _________________________   State: ______    Zip: __________________
Credit Card No.:  ______  -  ______  -  ______  -  _______    
Expiration (mm/yy):  ____  / ____       CVV2  (3-digit number on back) _______
questions:
Sales@PipersEnterprises.com or call 913-269-0497
Main Patch
   1 - 9    =  $4.00
 10 - 19   =  $3.60
 20 - 49   =  $3.40
 50 - 99   =  $3.00
To mail in payment print off this page and proceed below
Contact us for prices on Custom Patches (see samples below).
 Initial quantity must be at least 20
Teddy Bear
Biker Bear
Now stocking 2012, 2011 & 2010 PBR Pins
1 1/8"
1 - 9 = $4.00
10 - 24 = $3.6
0
25 - 49 = $3
.40
2012, 2011 & 2010 Rocker:
1 - 19   =  $1.50
20 - 49  =  $1.25
50 - 99  =  $1.00
Year Rockers
Polar Bear Ride Pins
2010 actual pin scan
Pin Size - 1 1/8" diameter
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