2014 Bed Race Application

Page 1

Bed Race 2014

PLEASE FILL OUT BELOW **Please make checks payable to Boys & Girls Club of Noblesville** ______________________________________ Team Name

______________________________________ Rider Name

Bed Race

D-O-B

______________________________________ Runner (1) Name

D-O-B

______________________________________ Runner (2) Name

D-O-B

______________________________________ Runner (3) Name

D-O-B

2014

______________________________________ Runner (4) Name

D-O-B

______________________________________ Alternate Name

D-O-B

______________________________________ Team Contact Name

Phone #

All Bed Racers MUST sign the Waiver of Liability and acknowledgement of the Bed Race Rules and Regulations before participating in the Race! No Racers will be allowed to complete without signing these forms. Rosters are not adjustable! Team members must be 16 years of age!

For Information Contact

Boys & Girls Club of Noblesville Abigail Rinehart. Unit Dir. 317-773-4372 Noblesville Parks & Recreation Mike Hoffmemister, Asst. Director 317-776-6350

All proceeds benefit summer camp scholarships.


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