Hosted by Vermont Adaptive Ski and Sports

Vermont 100 Endurance Race
July 19-20, 2014

benefitting
Vermont Adaptive Ski and Sports

DINNER AND BRUNCH
EXTRA TICKETS

EXTRA DINNER TICKETS FOR Friday, July 18th

$20.00 X  #_________

$__________

EXTRA BRUNCH TICKETS FOR Sunday, July 20th

$20.00 X  #_________

$_________

TOTAL AMOUNT ENCLOSED

 

$_________

(MAKE CHECK OUT TO Vermont 100 Endurance Race
CHECKS MUST BE RECEIVED BY July 2nd, 2014.

Please mail form and check to

    Vermont 100 Endurance Race
    PO Box 612
    Brownsville VT 05037

 

RUNNER'S NAME (PLEASE PRINT) _____________________________________________

_____________________________________