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2010 Century and Half Century Bike Ride Registration

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Offline/print registration & mail-in payment

Early-bird registration through Aug 31, 2010. Save $5/registration!
Your contribution is tax deductible.

 Registration Options are:

All Ride registrations include cook-out!

Century Ride: Full - $50.00 early/$55 reg
Century Ride: Half - $50.00 early/$55 reg
10-mile Family Ride - $35.00 early/$40 reg
20-mile Family Ride - $35.00 early/$40 reg
Kids 10 and under FREE 
with paying adult (Family-ride only) - $0.00

Cookout Only - $35.00 early/$40 reg

Additional Donation/Donation-Only - $any amount
Instructions:

1. Enter your info below, then print.
2. Print & Sign the release form found here for each participant.
 
Main contact info:

Mailing Address:
City:
State:
Zip:

Ski Team Name:   |  Phone/Cell Number:
Email:
Volunteer:
If you would like to volunteer but aren't registering for the event, please contact Anne.
Additional Donation/Donation-Only: $.00


Individual Participant info:
Please print & Sign the release form found here for each participant.
Participant 1 Name (First Last): 
 		Registration/Donation Type & Amount: 
Age:   |   Gender:  Male  Female   |  Email:

 

Participant 2 Name (First Last): 
 		Registration/Donation Type & Amount: 
Age:   |   Gender:  Male  Female   |  Email:

 

Participant 3 Name (First Last): 
 		Registration/Donation Type & Amount: 
Age:   |   Gender:  Male  Female   |  Email:



 

Participant 4 Name (First Last): 
 		Registration/Donation Type & Amount: 
Age:   |   Gender:  Male  Female   |  Email:

 

Participant 5 Name (First Last): 
 		Registration/Donation Type & Amount: 
Age:   |   Gender:  Male  Female   |  Email:

 

Participant 6 Name (First Last): 
 		Registration/Donation Type & Amount: 
Age:   |   Gender:  Male  Female   |  Email:

 Particpant(s) total(s) above:

 $_________

Additional Donation:

 $_________

Grand Total:

 $_________

Please mail your check, made-out to:
"Shelley Glover Sports Education Foundation"
to:
 SGSEF c/o Danika Stitgen, Treasurer
Wealth and Wisdom of Wisconsin
8500 Greenway Blvd, Ste 101
Middleton, WI 53562