Bethel Horizons Bike & Walk-A-Thon Registration - Saturday, June 2, 2012

Name(s)
Email
Phone Number
Address
City
State Zip


What will you do? (check all that apply)


I/We will walk from to
I/We will ride from to
I would like to volunteer from 8:30-11:00 a.m. on Saturday, June 9 to shuttled cars.
I will walk or ride on a different day.
I will not walk/ride in the Bike-A-Thon, but am making a taxdeductible donation of $ .
I will need my car shuttled (Available to first 20 registration requests).
I/We will need a bike shuttled. Number of bikes
I/We will stay overnight at Horizons on Saturday, June 9. Reservations Required.* Number
I/We will have dinner/breakfast at Horizons.
Number for Dinner Number for Breakfast


*Reservations are first come, first serve. Contact Phil or Mary Lou Dzick at 608.241.4579 or pmlzik@att.net.
Please make checks payable to Bethel Horizons. Registrations are due by Sunday, May 22, 2012.
Drop off registrations at Bethel Lutheran Church or mail to Bike-A-Thon, 3621 Hovde Road, Madison, WI 53704