2011 Vermont 50 MT Bike or Ultra Run

Pledge Form

Your pledges and all proceeds  from the Vermont 50 go to Vermont Adaptive Ski and Sports, a non-profit that provides sports and recreational opportunities to people with disabilities.  Contributions are fully tax-deductible.

Name

Address

City, State, Zip

Donation Amt

Date

Comment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Amount Collected:

 

Entrant Name: _______________________  City, State: __________________ Bib# _____

Race

Min Pledge

Runner

$0

Mt Bike

$0

Team

$450

All pledges must be turned in at registration check-in on Saturday, September 24th, 2011
Pledge minimum to have your entry Entry fee refunded:

 

Vermont Adaptive Ski and Sports, P.O. Box 139, Killington, VT 05751.  802-786-4991
http://www.vermontadaptive.org