Registration Form

Print and mail in this form with your donation

Name of Entrant(s):  _________________________________________________________

Email:    _____________________________

Address:     _________________________________________________________________

Day Phone: ________________________  Night Phone: ________________________

Height: _________________    T-shirt Size: (M-XXL) ________________

Entry fee:  $80 per person

All checks should be made payable to: Rett Association of Illinois

Donation Enclosed:    ___________________

DEADLINE FOR ENTRY IS 10PM MARCH 9, 2007

Mail to :
Adam Lavey 
210 S. Des Plaines #502
Chicago, IL 60661