CONVOY REGISTRATION FORM
			11th ANNUAL CONVOY
	S e p t e m b e r    11 ,   2 0 1 0
			Bedford, PA
	Activities 9:00 a.m. til 5:00 p.m. - Convoy begins at 1:30 p.m.
	Same day registration opens at 7:00 a.m.
		Registration Fee $60.00
	Waived if you raise $250 or greater in pledges this year
				DRIVER
	Name:
	Address:
	Phone:
	E-Mail:				T-shirt Size:
	Are you able to take riders?
	Type of Truck:				Trailer __ yes  __ no    Size _____
				COMPANY
	Name:
	Address:
	Phone:
	Checks should be made payable to "Make-A-Wish Convoy"
	Please return completed form along with total registration fees to:
			Make-A-Wish Convoy
			C/O J-Line Inc.
			P.O. Box 2326
			Altoona, PA  16603
			814.946.9344 phone
			814.946.1168 fax
	Be sure to visit our website for all the details at www.wishconvoy.com