Author: ROBERT ARTHUR

2023 Pre-Registration/Mail-In Form
SATURDAY ONLY EVENT!
DEADLINE 3-19-2023 at the COC MEETING!

Please use this for to submit payment for early registration for the 2023 Miracle ride which will be held June 3rd 2023
Please mail payment to: Indiana COC P.O. Box 341 New Castle, In. 47362
Make Check, Money Order, Cashiers Check Payable to: Richard Lester C/O COC
For Questions Related To Registering Please Contact;
Bryan 317-286-8152 or BA 765-606-5343 or Jimmy 317-414-5189
Registration is $50 for each registrant 16 and older and $25 for each registrant 15 and under. A Miracle Ride shirt will be reserved for you (COC MEMBERS ONLY) in the size you indicate below and can be picked up in the following area’s on the following dates!
SATURDAY JUNE 3rd from 10am-7pm at the COC Tent at the 8 Second Saloon.
Please complete registration below and mail in with your payment. *If you wish to register multiple people, please print and complete a separate form for each person and mail the forms together. Feel free to indicate “SAME” if contact information is the same for additional registrants. No Nicknames!
Please Print;
**CLUB NAME:____________________________________________________________________________
T-Shirt Size (Circle One)
Small Medium Large X-Large 2X-Large 3X-Large 4X-Large
**REGISTRANT GIVEN NAME:________________________________________________________________
** PHONE:________________________EMAIL:__________________________________________________
_________________________________________________________________________________________
AMOUNT COLLECTED $__________________
PAYMENT TYPE_________________________
INDIANA COC
P.O.BOX 341
NEW CASTLE IN. 47362
WWW.INDIANACOC.ORG INDIANACOC.BD@GMAIL.COM