June 17th, 2012
Tour de Unity Bike Ride
Tour de Unity Bike Ride
Registration Form
Registration Fee: $25 thru 6/6
$35 Day of Ride . Cannot Guarantee Shirt day of Ride
Complete this form and send it with your non-refundable, non-transferable registration fee to:
Must Also Include Wavier
Unity Gardens
PO Box 10022
South Bend IN 46680
Name:____________________________________
Address:__________________________________
City State Zip______________________________
Email Address______________________________
Date of Birth (must include year)___________________
Sex: Circle One Male Female
Home Phone: ______________________
Cell Phone: ______________________
Shirt size: circle one S M L XL XXL
Enclosed is my check payable to Unity Gardens Inc.
Sign: _________________________________________
