Honoring those who have made the ultimate sacrifice

Ride for Remembrance on July 24, 2010

7th Annual Registration Form

Name of registrant:________________________________________________

Name of rider (if applicable):________________________________________

Mailing address:__________________________________________________

                            __________________________________________________

Phone number (day):_________________________

Phone number (night):____________________________

e-mail address:____________________________________

_____Single Rider Bike @ $30.00:_______________

_____Double-Up Bike @ $50.00: ________________

         Amount of check enclosed:________________

Make checks payable to:   Wisconsin State Firefighters Memorial

Mail completed form to:   Wisconsin State Firefighters Memorial
                                           P.O. Box 248
                                           Wisconsin Rapids, Wisconsin 54495-0248

Please submit Pre-Registrations on or before July 17, 2010

If you have any questions contact: Ron Naab, Motorcycle Ride Event Coordinator
                                                                   Phone: 262-629-9749
                                                                   Email: ffmemorial@aol.com  

Lunch and evening meal are included this year.

Pre-registered people can go to a special line for their ride packet on ride day.