Website users: Please print out copy(s) of this form. Fill it out and bring it to the ride.

For a printer friendly version of this form, click here.

Contribution Form

Rider's Name_________________ Team Name_________________

Very Important:

• A minimum donation of $50.00 (or $45.00 for a tandem or team registrant/ $40.00 if you pre-register) is required in order to participate in the Tour of the Ozarks.
• All prizes, drawings and gifts will be awarded on the basis of the size of your donation to the DEF at the time of the ride.
• All donations must be received by the time of the ride to count toward your prize qualification.

Notice to Contributors: Please make your contributions payable to:
Diabetes Education Fund

For more information call: 573-341-2386 or email: scaron@rollacity.org