Ride for the Relay 2019
Highlight this form, print it, fill it out and mail it to the address at the bottom.
“Ride for the Relay 2019”
September 7, 2019
Starting Point: _________________________ Ending Point: _________________________
Telephone: _________________________________ Alt #: ___________________________
Military Veteran: Y / N Branch of Service: ___________________What years: ___________
Corporate Sponsor: ( ) $660
Pin: Sponsor: ( ) $330
Gold Sponsor: ( ) $132
Silver Sponsor: ( ) $66
Bronze Sponsor: ( ) $33
Rider/Driver Package: ( ) $132 --- T-Shirt Size: S M L XL XXL XXXL
Passenger Package: ( ) $132 --- T-Shirt Size: S M L XL XXL XXXL
Riders Package Includes: T-Shirt, Patch, Pin, Windshield Decal, 5 Raffle Tickets,
“All the way Gang” Plaque* and first time “All the way Gang” Patch*.
Passenger Package Includes: T-Shirt, Patch, Pin, 10 Raffle Tickets, “All the way Gang”
Plaque* and first time “All the way Gang” Patch*.
*To receive a plaque you must travel the whole “Ride for the Relay” Route.
*To receive the “All the Way Gang” patch it must be your first time to go All the Way.
Send 2019 Participant Application & check by August 15 to:
Ride for the Relay
C/O Rodger L. Fox
63 East Central Park Plaza
Jacksonville, Illinois 62650
Make all checks payable to Ride for the Relay or American Cancer Society