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   Jeff Wyand Miracle Ride  

  Saturday, August 17, 2013   


Become a Friend of the Jeff Wyand Miracle Ride motorcycle rally! Support the families and children in our region battling pediatric cancer with a donation of $100 or more. In return, your name or company name/logo** will be prominently displayed on a sign along the route on the day of the event. More than 500 event participants and many passing motorists will recognize your support of pediatric oncology at Vermont Children's Hospital.

 _______________________________________________________agrees to become a

Friend of the Jeff Wyand Miracle Ride motorcycle rally in the amount of $100.00.

 Contact Name: _________________________________________________________________

 Organization: __________________________________________________________________

 Address: _____________________________________________________________________

 City/State/Zip: _________________________________________________________________

 Phone: _______________________________ Email: __________________________________

 Name/Text to appear on sign: ___________________________________________________

 Check here if you would like to include your logo**: Alone _____ In Addition to Text _____

 Signed:___________________________ Date: _______________________________ 
(Organization Representative) 

**Email company logo (in either high resolution jpg or eps format)  to 
Emily Wright by August 9thth:**

 Please send payment and completed form to:
Vermont Children's Hospital
Development Office - 461OH4
111 Colchester Avenue
Burlington, VT 05401
Fax: (802) 847-2817

 For more information please call: (802) 847-1010

100% of funds raised stay in our region to support programs and services to benefit
the children of northern New York and Vermont.

 Thank You!

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