65 Miles for 65 Roses

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RIDER'S AGE (riders under 14 years of age must ride with an adult):

CHOOSE YOUR RIDE:15-mile30-mile65-mile

100.00 DONATION MINIMUM (you must check this box): I agree to raise a minimum 100.00 in donations by the day of the ride

T-SHIRT SIZE:

RIDER ENTRY FEE:

TO PAY BY CREDIT CARD: www.paypal.com

TO PAY BY CHECK: mail to Barbara Gode Wiles, 671 Overlook Dr., Cheshire CT 06410

HAVE A QUESTION? CONTACT: Steve LeClaire (203)915-7632 or EMAIL US HERE:

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ONLINE REGISTRATION(If you prefer, you may print this form, fill it out and and mail it in to: Barbara Gode Wiles, 671 Overlook Dr., Cheshire CT 06410)