Organizers of the rally are hoping to attract a younger breed of riders this year. Professional racers Eric and Ben Bostrom opened this year's activities. They are also staging an area of vendors and demos that cater to the energy drink participants.

The official grand marshal of the mayor's ride will be Lance Armstrong, a dethroned cyclist, who will formally begin the rally. Armstrong is a seven-time winner of Tour de France titles who was later on stripped of his winnings because of doping. While this decision has sparked some controversy, rally officials backed their decision by saying that Armstrong symbolizes the American spirit and represents a city that values second chances.

Law enforcement agencies have been preparing months ahead for the anticipated surge of the two-wheeled vehicles. With the number of participants expected to reach half a million, there are those who may overdo it and use the rally as an opportunity to commit a crime.

Emergency responders also noted that during a rally week, the daily calls that they receive would reach as high as 20 or even more compared to receiving only five in a non-rally week. This means that there is a need to cover extra shifts in order to treat cases which could include strokes, shattered bones, and inebriation.

Shawn Fischer, Sturgis Ambulance Director, says, "We see everything; every year is different. Last year was a medical year. The year before was a trauma year."

Last year's rally recorded at least six fatalities on area highways. Several arrests were also made which involved people who targeted minors for sex. There was also a man from Nebraska who died in a cycle accident along Highway 44 when his bike is said to have left the road.

Sturgis nurse supervisor Lynn Simons says, "We've kinda seen that the first Monday of the rally sometimes is one of our busiest days. Thursday sometimes is one of the worst injury days. It's started to be known as 'Black Thursday.'"

The staff personnel at Sturgis Regional Hospital stocks up on medications, chest tubes, splints, and cast materials to treat broken bones. There will be five more doctors to give an extra hand in treating the patients. Normally, the emergency room of a smaller hospital would have 15 visits per day. This number is expected to grow between 50 and 70 when the rally begins in full swing. Those who will have serious injuries will have to be transported to Rapid City either by an ambulance or a helicopter.