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					Bike ‘n Hike Team Roster
Team captain: Please complete this form by listing all team members. Please make a copy of completed
form for reference before sending in registration. Note team members competing for farthest distance
traveled can list multiple routes.

Organization Name _____________________________________________________
Team Name ___________________________________________________________
Team Captain Name/Address _____________________________________________
Captain’s phone and email ________________________________________________
Address for packet and shirt deliveries _______________________________________

                                                       10     35     60      3k      form
      Member Name                        shirt size   mile   mile   mile    hike   collected   paid

  1

  2

  3

  4

  5

  6

  7

  8

  9

 10

 11

 12

 13

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 15

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 20


*no minimum for team size
                                        PLEDGE FORM
NAMI Bike ‘n Hike 2011

Participants and friends of NAMI are encouraged to raise pledges for the ride.
The Bike ‘n Hike is NAMI Racine’s primary pledge campaign.

Participants and individual fund-raisers are awarded with prizes at the following pledge levels:
$150, $300, $500, $1,000

Gifts may include: fitness monitor, pedometer, portable hammock, digital camera, event apparel
or local bike shop gift certificate. The donor can also donate the prize back to NAMI Racine
County for a special education or support program. Be sure to clearly enter sponsor info below.

ALL PLEDGE MONIES MUST BE COLLECTED AND SUBMITTED WITH FORMS BELOW
TO NAMI RACINE NO LATER THAN THE DAY OF EVENT.

Please PRINT               ________________________________
                  NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                                           Pledge

Email   ____________________Phone________________                          $___________



Please PRINT               ________________________________
                  NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                                           Pledge

Email   ____________________Phone________________                          $___________



Please PRINT               ________________________________
                  NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                                           Pledge

Email   ____________________Phone________________                          $___________
Please PRINT               ________________________________
                 NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                    Pledge

Email   ____________________Phone________________   $___________



Please PRINT               ________________________________
                 NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                    Pledge

Email   ____________________Phone________________   $___________



Please PRINT               ________________________________
                 NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                    Pledge

Email   ____________________Phone________________   $___________



Please PRINT               ________________________________
                 NAME: First & Last
Address ______________________________
City and State _________________
Zip code ___________________

                                                    Pledge

Email   ____________________Phone________________   $___________

				
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posted:11/3/2012
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