Tour de Timor Registration Form

A bike ride in support of the people of East Timor


Rider Name_____________________   Phone _________________


Address___________________________________  E-mail_________________


Use this form to collect donations from your friends, family and coworkers. (Kids 12 and under ride free.) Bring this form and your donations on the day of the ride. Collect donations of $25 or more and you'll get a free t-shirt! All proceeds directly benefit solidarity programs for the people of Ainaro, East Timor.


Name of Sponsor

























































Checks may be made to “ETAN/Madison”


ETAN/Madison meets the 1st and 3rd Thursdays of each month, 7:30 pm at Mother Fool’s Coffee Shop


For more information // (608) 241-2473 //