2025 Ride With Mike Registration Form

2025 Ride With Mike Registration Form

Please fill out the form below to pre-register for our annual Ride With Mike
I would like to register as

2025 Ride With Mike Registration Form

Thank you for sponsoring or Volunteering at our annual Ride with Mike!
Company Name*
Contact Person*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

I/we cannot attend, but I would like to make a contribution of $
Sponsorship Levels*
prevnext( X )
Survivor6 riders, recognition on all promotional materials
$300.00 Quantity
Item subtotal:$0.00



Caregiver4 riders, recognition on all promotional materials
$200.00 Quantity
Item subtotal:$0.00



Angel of Mercy2 riders, recognition on all promotional materials
$100.00 Quantity
Item subtotal:$0.00



Basket of HopeI would like to donate raffle item (We will contact you)
$ Free



Total

$0.00
Please make checks payable to:

NYOH Community Cancer Foundation

Please mail your checks to:

PO Box 11321
Albany, NY 12211-1321
Please upload your company logo to be used on promotional materials

Cancelof

How many people would you like to register?*

Please enter the first and last name of EACH person you would like to register

	First Name	Last Name	Rider or Attendee
Rider 1
Rider 2
Rider 3
Rider 4
Rider 5
Rider 6
Rider 7
Rider 8
Rider 9
Rider 10

Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
How many people would you like to register?

Please enter the first and last name of EACH person you would like to register*

	First Name	Last Name	Attendee Type
Attendee 1
Attendee 2
Attendee 3
Attendee 4
Attendee 5
Attendee 6
Attendee 7
Attendee 8
Attendee 9
Attendee 10

I/we cannot attend, but I would like to make a contribution of $
Please make checks payable to:
NYOH Community Cancer Foundation

Please mail checks to:
PO Box 11336
Albany, NY 12211-1321
How would you like to pay?*

Thank you for your support! Please click submit to complete your registration.

If you have any questions, please contact Darlene Casale at 518-857-7642 or ciicommunity@callanan.com
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