Shenandoah Co. 4-H Bike-A-Thon Registration
Sunday, April 28, 2024 (Rain Date May 5, 2024)
2:00-4:00 p.m.
Bike helmet required for participation

Registration desk opens at 1:00 pm

Ages 5-19 are welcome (cloverbuds, 4-H'ers, 4-H parents and leaders, other county youth and adults)
*Meet at Shenandoah County Government Center Parking Lot, Woodstock - Entrance #1 (clock tower entrance).

Sponsored by:  Shenandoah County 4-H Council in cooperation with Shenandoah County Ruritan Clubs
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Email *
Participant First Name *
Participant Last Name *
Parent or Guardian Name *
Email and Cell phone contact for Parent or Guardian *
Is the participant a current 4-H Member? *
Name of 4-H Club *
Age Group (as of 9-30-23) *
Required
The following person will be with me and is willing to serve as a lap counter that day.
My t-shirt size is *
For Office Use Only
Bike Number           ______________________
Total Miles Ridden  ______________________
Total Number of Sponsors  ______________
Total of Contributions  ___________________

Amount Received                            Date

_____________________________________________________

_____________________________________________________

________________________   Total


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