PinewoodDerbyRegistration - South Carolina Boys Ministries

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Please print out form below, fill out and mail (with fee) to:

YCE Dept (Rendezvous Reg.) PO Box 309, Mauldin, SC 29662.

Name: ______________________________________ Date: ______________________

Church: _________________________________________________________________

Address: ________________________________________________________________

City: _______________ State: ____________________ Zip: ______________________

No. of Boys Participating: ________________ No. of Men Participating __________

Fees

Before March 17th $1.00 per car after March 17th $1.50 per car

Total number of Partcipants: __________

Times Fee: __________

Total = __________

Amount Enclosed: _____________ Check # _______________

Names List Form

(Please Print Clearly)

Name Age Name Age

_________________ _____ _________________ _____