Dairy Products Inc.

Ride for WishesTM
In me
mory of Chuck Worden
to benefit the
Make-A-Wish Foundation of Minnesota

Brought to you by:


92 KQRS


Fury Motorcycles


Streamline Design

T-Shirt and Tank Top Sales
Shipping costs are $3 per t-shirt.

This form accepts payment via
Solution Graphics
Ride for Wishes respects your privacy. We will not sell or give away your personal information.

First Name:       Last Name: 
Mail Address:     Apt: 
City:     State:     Zip: 
Phone: ( ) -  Ext:
E-mail:

1st Annual T-shirts from our 7/1/2005 event - Indicate quantity below each size
T-Shirt Medium
$5.00/ea
T-Shirt Large
$5.00/ea
T-Shirt XL
$5.00/ea
T-Shirt XXL
$5.00/ea

Ladies String
Tank Top Medium
SOLD OUT
$5.00/ea
Ladies String
Tank Top Large
SOLD OUT
$5.00/ea
Ladies String
Tank Top XL
SOLD OUT
$5.00/ea

2nd Annual T-shirts from our 7/16/2006 event - Indicate quantity below each size
T-Shirt Medium
$5.00/ea
T-Shirt Large
$5.00/ea
T-Shirt XL
$5.00/ea
T-Shirt XXL
$5.00/ea

Ladies String
Tank Top Medium
$5.00/ea
Ladies String
Tank Top Large
$5.00/ea
Ladies String
Tank Top XL
$5.00/ea

I would like to help the kids with an additional cash donation of: $
Shipping :   Total :