PRE-REGISTRATION FORM

RIDE FOR THE CHILD 2006

 

Name _________________________________________________

 

Address  ______________________________________________

 

               City ____________________ State ____ Zip ___________

 

Phone __________ Email  __________________

 

Cost:                   $25 per vehicle (includes 1 hand)

                

                                  $10 per Additional Hand

 

                                  $15 Commemorative Shirt (indicate quantity)

                                                   ___S       ___M     ___L   ___XL

                                                   ___2X    ___3X

 

                                  $ 5  Commemorative Pin

 

                 Total:  $_________  (Please indicate what items

                                  you are paying for.)

 

 

Website Home of

Prevent Child Abuse Affiliates of the Upstate—

helping Keep Kids Safe!

 

 

Ride for the Child 

10th Anniversary charity poker run!

Pre-Registration Form

 

The first 25 participants to mail in this form and non-refundable payment will receive one FREE   T-Shirt!  Once we receive your payment, a receipt will be mailed indicating if you won a free shirt.  Pre-registration payments must be received by April 1st.

Questions?  Call 864-898-5583

Make checks payable to & mail to:

 

                 Prevent Child Abuse Pickens County

1899 Gentry Memorial Hwy

Easley, SC  29640