| CONVOY REGISTRATION FORM | ||||||||
| 10th ANNUAL CONVOY | ||||||||
| S e p t e m b e r 12 , 2 0 0 9 | ||||||||
| 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 "Wish Convoy" | ||||||||
| Please return completed form along with total registration fees to: | ||||||||
| Convoy | ||||||||
| C/O Make-A-Wishâ Foundation | ||||||||
| 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 | ||||||||