Register for the 6th Annual Ride for Rescue

Name  

Address

City     State

Zip Code  

Telephone Number  

E-Mail Address (required)  

I would like to join Boise Rescue Mission's mailing list

I am registering for one rider - $25.00

I am registering for a couple - $35.00

I will be paying by:

Check.  Make checks out to: Boise Rescue Mission              Ministries, and mail to

Attn: Leslie

   P.O. Box 1494

              Boise, ID 83701-1494

Credit Card

           Card Type - Visa Mastercard Discover American Express

           Card #

    Name as it appears on card

           Expiration Date

    Your credit card will be billed on the Thursday following your purchase.  (i.e. if you purchase a book on Friday the 9th, your card will be charged on Thursday the 15th.)