1st Annual
"Ride for the Relay Reunion"
2016
Decorah, Iowa
Please mark one of the below:
Motorcycle Rider ( )
Passenger on Motorcycle ( )
Auto Driver ( )
Auto Passanger ( )
Non-Riding/Driving Sponsor ( )
Name: _____________________________________________________________
Address: _____________________________________________________________
City/State/Zip Code: ______________________________________________________
Telephone: ( ) ________, ____________
eMail Address: _______________________________ @_______________________
Corporate Sponsor: ( ) $660
Pin Sponsor: ( ) $330
Non-Rider Gold Sponsor: ( ) $132
Non-Rider Silver: ( ) $66
Non-Rider Bronze: ( ) $33
Banquet Tickets only ( ) $35 each
Motorcycle Rider/Auto Driver Package: ( ) $132 ---------- T-Shirt Size: _________
Above package includes: Banquet Ticket, T-Shirt, Patch, Pin, Windshield Decal, 5 Raffle Tickets
Motorcycle/Auto Passanger Package: ( ) $132 ---------- T-Shirt Size _________
Above Package includes: Banquet Ticket, T-Shirt, Patch, Pin, 5 Raffle Tickets
Non-Riding/Driving Sponsor ( ) $66
Above Package includes: Banquet Ticket, Pin, 1 Raffle Ticket
Send all Sponsorship Applications 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 the American Cancer Society