Bike & Roll to School Day Registration

Contact Name *

Title

School Name *

Street Address *

(materials are shipped via UPS; please no P.O. boxes)

City *

County *

State *

Zip Code *

Email *

Phone Number *

How Many Students Will Be Involved? *

This is the number we use to determine the amount of materials to send to your school

Grades

Example: K-2, K-5, K-6, 6-8, etc.

Would you like to receive Bike to School Day stickers for your students? (Max of 200 per school. Due to current shipping logistics, registration after April 13 will be unable to receive B2SD stickers).

Yes

No

In addition to Bike to School Day

Please register me for the next Walk to School Day (held in October)

Please send me more information on Safe Routes to School

Photo Permission

I hereby grant the Michigan Fitness Foundation the right to use and publish photographs of all those participating in our Bike to School Day, and/or Walk to School Day event(s).

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