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Cycling & Running/Walking Event
September 29, 2012
Register for this Cycling & Running/Walking Event
First Name
Last Name
Street
City
State
Zip Code
Phone
Email
Event
100K Bike Ride
26 Mile Bike Ride
10K Run/Walk
5K Run/Walk
EXTRA BBQ Guests
0
1
2
3
4
5
Tickets in addition to the tickets included with the fund-raising level selected.
Tickets are a $5 donation per ticket- donation added to registration payment.
Shirt Size
S
M
L
XL
XXL
I would like to make a donation for an additional $90 and receive a free jersey for my contribution.
Fund-Raising Level
LEVEL ONE- Raising $89- includes 1 BarBQ ticket
LEVEL TWO- Raising $250- includes 1 BarBQ ticket
LEVEL THREE- Raising $500- includes 1 BarBQ ticket
LEVEL FOUR- Raising $1000- includes 1 BarBQ ticket
Registration Payment
$39.00 (Minimum)
$89.00 (Entire Fee)
$50.00 (Minimum)
$100.00
$150.00
$200.00
$250.00 (Entire Fee)
$100.00 (Minimum)
$150.00
$200.00
$250.00
$300.00
$350.00
$400.00
$450.00
$500.00 (Entire Fee)
$200.00 (Minimum)
$250.00
$300.00
$350.00
$400.00
$450.00
$500.00
$550.00
$600.00
$650.00
$700.00
$750.00
$800.00
$850.00
$900.00
$950.00
$1000.00 (Entire Fee)
Registration deposits are non-refundable
Thank you for your donation. The Source is a 501(c)(3), Federal Tax I.D. #47-0855213, and is able to provide FREE resources to youth workers because of people like you.
**Please note that for those who participate in the event, only the portion of your donation that is above the cost of goods and services provided to you from this event will be tax deductible. For example, if you register for Level One and pay the whole $89 yourself, then your goods and services provided would be $14. At Level Two, your goods and services amount would be $92. At Level Three, your goods and services amount would be $182. At Level Four, your goods and services amount would be $432. But also note that for all of your family or friends who sponsor you by giving to the ministry, their entire donation is tax deductible.