ASMF Benefit Dinner and Silent Auction

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 First Annual “Night with the Supercross Stars” benefit dinner and silent auction presented by Leatt Brace, Shock Doctor and The Road 2 Recovery Foundation.  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, most notably - the Amateur Motocross Nationals.

As a guest for the evening you will enjoy a casual dining experience with Ricky Carmichael, Tim Ferry, Andrew Short, Ivan Tedesco and others to be announced soon, bid on great silent auction items and the chance to win some great gifts that will be raffled off.   

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”

presented by Leatt Brace, Shock Doctor and Road 2 Recovery Foundation

Ruth’s Chris Steakhouse Jacksonville, Florida at 6pm

Guest Level of Participation:

 Silver level – dinner only:

[   ] Individual: $150

[   ] Table of eight: $1,100

 Bronze level – includes for each guest: dinner, ticket to Jacksonville SX and swag bag

[   ] Individual: $250

[   ] Table of eight: $1,800

Platinum level – includes for each guest: dinner, ticket to Jacksonville SX, private suite access and swag bag

            [   ] Individual: $350

            [   ] Table of eight: $2,500

*Only eight tickets at this level will be sold

Tickets must be purchased by March 31, 2009.

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



Christine Chmielewski: (904) 899-3366 
501c(3) Tax deductible ID # 57-1160023
Night events include: Dinner, Raffles, Silent Auction, Photograph session, Cash Bar