July 4th Extravaganza
REGISTRATION FORM
Proceeds to benefit LEAP (www.LEAP-Lanesville.org); Neighbors Helping Neighbors
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Make checks payable to: "LEAP"
Print form and return to:
Lanesville July 4th Extravaganza
PO Box 7144
Gloucester, MA 01930
Questions? Email us here. More details? Click here!
Name: ________________________ Email: _____________________________
Street Address: _______________________________ City: _____________________
State: _______ Zip: ___________Daytime phone: ___________________
| Pricing | before June 15 | after June 15 |
|---|---|---|
4K road race/BBQ (must complete application) |
$13 X ____ = |
$15 X ____ = |
1 mi Fun Run/BBQ (must complete application) |
$5 X _____ = |
$6 X _____ = |
BBQ and games/float building/bike decorating |
$4 X _____ = |
$5 X _____ = |
age 6 and under limited BBQ/games |
$3 X _____ = |
$3 X _____ = |
events only (games/float/bike) - no food |
$2 X _____ = |
$2 X _____ = |
raffle tickets (must be present to win) |
$1; 6 for $5 ____= |
$1; 6 for $5 ___= |
too young to eat or play games |
free! |
free! |
LEAP donation: |
||
| TOTAL for all events enclosed: |
This is a no alcohol event, please!
Race/fun run participants must fill-out attached application