On Line Donation Form

Poth Ride to Remember Online Donation Form

Use This form to Donate $35.00 to $100.00 in your name or in the name of a sponsored rider.For Multiple Riders/Donations, Add Each donation to cart before checkout

Select Amount to Donate	$35.00 $50.00 $75.00 $100.00
Enter Rider’s Name You are Sponsoring or Leave blank for Donation Only
Enter Sponsored Rider’s Age or Leave blank for Donation Only
Select Ride or Donate Only	Donate Only Family Ride(12 Miles) 22 Mile Ride 44 Mile Ride Metric Century (66 Miles) 5 K Run
Select Shirt Size or Donate Only	Donate Only Small Medium Large X Large XX Large