Charity Auto Event To Raise Funds
 for Youth Programming

Registration
To participate in Drive for Kids 2011, complete the online form below or click  here to download an event flyer.  If you register online using the form below, click the "submit" button after completing the form and you'll will have the option to make payment online using your credit card through PayPal.   You may also print out the form below and mail with your payment to Drive for Kids/ Bolder Options 2100 Stevens Avenue South, Minneapolis, MN  55404.

Individual Driver--$45
      ($55 after 10/3/11)
(1 vehicle, includes all passengers/1 free t-shirt)
No. of passengers (in addition to driver)
Optional:
Make:  
Model: 
Year:   
Color:  

Club
 Business 		$250 per organization
($275 after 10/3/11)

No. of vehicles (up to 6, 
       1 free t-shirt per vehicle)
Total number attending
First Name:   

  Last Name:

Business/
Organization:
Address:
City:
State:

ZIP: 

Phone:
Email:
Email (confirm):
Note:

If you are printing and mailing this form and wish to pay by credit card, please provide the following information:

Credit Card Number:   __ __ __ __    __ __ __ __    __ __ __ __    __ __ __ __

Expiration Date: _____ / _____ / _____

Signature ________________________________________

Thank you!