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Participation Form
Maynard Monster Road Race Wellness Fest
September 7, 2008

* Required fields
Name *
E-mail Address *
Business Name *
Address *
City *
State *
Zipcode *
1st Time Participating
Have Participated Before
Booth Offerings the Day of the Wellness Fest *
Best Phone # to Reach You *
Donation For the Raffle (optional)
Item Being Donated for the Raffle
Donation for Runner's Goodie Bag (250 of Item Needed) Examples: discount coupons, brochures, flyers of classes or events, give away with business info on it (pens, magnets, etc.)
Item Being Donated for Runner's Goodie Bag
Contact me: I am interested in Renting a 10 X 10 Pop Up Tent at a Discount
Type your initials in box. I understand that I will have an assigned 10 X 10 Space. I will arrive for set-up by 10 am. I am responsible for bringing all of my own set up materials for the day of the event. If I do not show up for this event my $25 will not be refunded. If I cannot make this event, I will need to contact Kelly Bollman, no later than September 1st to receive a refund of my $25.
Additional Comments

I have read and agree to the Privacy Policy *

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Please Mail your $25 Participation Fee to Simple Balance, 14 Nason Street, Suite 205, Maynard, MA 01754.

Make Checks Payable To: Simple Balance

(I will be writing 2 checks once all money is received: One check to  Encore (Moon Bounce Staffing) and One check to Assabett Valley Boys and Girls Club).

Thank You!