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To
register more than one person,
submit form, then click reset and submit a new form. |
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Check here
only if resubmitting corrected form:
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*
= Required field |
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*First Name: |
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Middle Initial
or Name: |
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*Last Name: |
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*Address: |
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*City: |
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*State: |
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*ZIP: |
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*Work/Daytime Phone: |
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*Email: |
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Employer: |
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*T-Shirt
Size: |
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*Rider
Age: |
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*Plan
to Ride: |
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Team Groupings |
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If
you would like to be grouped with one or more cyclists, please
select a team name and team captain and enter team's name and
captain's name with each team-member's
registration. |
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Team Name: |
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Team Captain: |
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Cyclist Payment Information |
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Please note that there are two levels of payment —Registration
and Pledge — and that both must be made on before the
day of the event. (
Your registration is not valid unless registration fee is received.) |
*Payment Amount:
(See payment
instructions below) |
Registration fee:
$20.00 per individual ($30.00 after 10/4/02).
$10.00 per team member ($20.00 after 10/4/02).
Minimum pledge (due by day of event):
$25.00 per individual.
$40.00 per team (payable by Team Captain). |
*Method
of payment:
(Be sure to finish
payment process below) |
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Scroll down to find Registration Submit button
Your registration is not valid unless registration fee is
received. |
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To Pay Online |
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To pay online, simply click the
Pay Now button below. This will
open another window and send you to an online donation website, Network for Good,
founded by
the AOL Time-Warner Foundation and AOL, Inc.; the Cisco Foundation
and Cisco Systems, Inc.; and Yahoo! Inc.
This is an SSL secured site. Your personal information will be
held in strictest confidence (see their
Privacy and
Security disclosure notice). We utilize this method because the
cost of accepting credit cards is neither passed through to us,
nor is it deducted from your donation; indeed, processing costs
are completely absorbed by the sponsoring organizations of the
Network for Good!
Once you've entered the donation site, be sure to leave the
preference button set to "provide my name and e-mail address to
the charity" so we can associate your donation with your
registration form. If you'd like to restrict your payment to a
specific program(s) of the
Rotary Club of Damascus Foundation,
please enter the name of that program in the
Designation (Optional) field on the
site. If you do not restrict your donation, it will be
placed in the General Fund of the Foundation to be utilized for
programs of the Foundation as determined by the Board of
Directors.
After completing your donation online, close the Network for
Good
window and return to this window. (You will receive an e-mail
confirmation of your donation from Network for Good.) You can then
finalize your registration by clicking the gray submit button
further below.
Please be sure to also press the Donate Now button at the
Network for Good site.
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Scroll down to find Registration Submit button
Your registration is not valid unless registration fee is
received. |
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To
Pay by Mail |
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To pay by mail, please make checks payable to the
Rotary Club of Damascus Foundation, Inc. and mail to:
ROTARY CLUB OF DAMASCUS FOUNDATION, INC.
Attn: Chuck Kenney
P.O. Box 4
Damascus, Maryland 20872-0004 |
