Pioneer Ministries - Event Registration

Pioneer Ministries - Metric Century Bike Ride September 4th 2010 - Enter online or Print and Mail to:
	Pioneer Ministries Metric Century Bike Ride P.O.Box 822 St. Helens OR. 97051	For more information call: 503-396-6514
	First Name: Last Name Gender Birthday Email Day Phone Evening Phone Address City State Zipcode Emergency Contact Name Emergency Contact Phone Name of Tandem Partner	Purchase Now !
		Single Rider @ $40 ea.

		Tandem Team @$75 per team.
		No refunds allowed after Friday August 6th 2010

		If paying by check, make checks payable to Pioneer Ministries - Please write "Bike Ride" on the memo line.

		Please complete the 2010 Accident Waiver and Release of Liability Form at check in.

		All Participants MUST sign in before you will be allowed to participate!

Event Tee-Shirts -Gilgan 100% ring spun T-Shirt, sizes S, M, L, XL, 2XL = $17.00

Hanes 50/50 Cotton/Polyester T-Shirt, 3XL, 4XL, 5XL = $17.00