Sponsored by
Sponsored by
Heart of the North Lions Club Bark River Lions Club Northern Sun Winery
Saturday, September 10, 2016
6:00 pm at the Bark River Off Road Race Track
Mixed terrain course starts at the Off Road Track & finishes at Northern Sun Winery Registration from 4:30pm to 5:45pm (Eastern)
Race starts at 6:00pm (Eastern)
Registration: One name per entry form. Waiver on back must be signed to complete valid form. Last Name: ___________________________________ First Name: __________________________________ Address: _________________________________________________________________________________ City: __________________________ State: _____ Zip: ______ Daytime Phone: _____________________ Email: _________________________________________________________
PAYMENT ENTRY FEES ARE
Sex: ____ Age as of 09/12/14: 9/9/2016 _____ _________ Birthdate: Birthdate ___________ _____________ _______
NON-REFUNDABLE Family members limited to 4 Circle Category: 1. Single Registration or 2. Family Registration living in same household Circle One Division: Early Bird Discount Rate: 1. 10 and under 2. 11-14 3. 15-19 $25 single or $75 family 4. 20-25 5. 26-30 6. 31-35 7. 36-40 8. 41-45 MUST be postmarked by 9. 46-50 10. 51-60 11. 60+ Saturday, August 20, 2016 Rate after August 20, 2016 Circle One Adult Unisex Shirt Size (included in registration): $30 single or $90 family S M L XL XXL Make checks payable to: Shirt only guaranteed with Early Bird Registrations Heart of the North Lions Club Additional shirts may be purchased for $10 each Mail form(s) and payment to: Advanced payment required by August 20, 2016 to guarantee size requested Strides Off the Vine 2016 S M L XL XXL c/o Davida Mooers 2964 D Road Bark River, MI 49807 UPRRC Member? Y or N $2.00 UPRRC Member Discount Visit our website at www.heartofthenorthlions.org for club and event information and race registrations. Proceeds benefit diabetes awareness.
For more information contact Sue Anthony 906-399-9212 or Judy Davis 906-399-7288
Heart of the North Lions Club Bark River Lions Club Northern Sun Winery
Saturday, September 10, 2016
6:00 pm at the Bark River Off Road Race Track
Mixed terrain course starts at the Off Road Track & finishes at Northern Sun Winery Registration from 4:30pm to 5:45pm (Eastern)
Race starts at 6:00pm (Eastern)
Registration: One name per entry form. Waiver on back must be signed to complete valid form. Last Name: ___________________________________ First Name: __________________________________ Address: _________________________________________________________________________________ City: __________________________ State: _____ Zip: ______ Daytime Phone: _____________________ Email: _________________________________________________________
PAYMENT ENTRY FEES ARE
Sex: ____ Age as of 09/12/14: 9/9/2016 _____ _________ Birthdate: Birthdate ___________ _____________ _______
NON-REFUNDABLE Family members limited to 4 Circle Category: 1. Single Registration or 2. Family Registration living in same household Circle One Division: Early Bird Discount Rate: 1. 10 and under 2. 11-14 3. 15-19 $25 single or $75 family 4. 20-25 5. 26-30 6. 31-35 7. 36-40 8. 41-45 MUST be postmarked by 9. 46-50 10. 51-60 11. 60+ Saturday, August 20, 2016 Rate after August 20, 2016 Circle One Adult Unisex Shirt Size (included in registration): $30 single or $90 family S M L XL XXL Make checks payable to: Shirt only guaranteed with Early Bird Registrations Heart of the North Lions Club Additional shirts may be purchased for $10 each Mail form(s) and payment to: Advanced payment required by August 20, 2016 to guarantee size requested Strides Off the Vine 2016 S M L XL XXL c/o Davida Mooers 2964 D Road Bark River, MI 49807 UPRRC Member? Y or N $2.00 UPRRC Member Discount Visit our website at www.heartofthenorthlions.org for club and event information and race registrations. Proceeds benefit diabetes awareness.
For more information contact Sue Anthony 906-399-9212 or Judy Davis 906-399-7288
