Registration Form
Sean Ashley Tour D Autism 2010
Saturday, August 7, 2010
New Waverly ISD Sports Complex9452 Highway 75 South New Waverly, Texas
You may register online at Active.com or print and mail this form to the address below.
o Early Bird Entry Fee* $30.00
o Regular Entry Fee $35.00
o Late Entry Fee** $40.00
o Donation $________
TOTAL $ _________
Make Checks payable to The Sean Ashley House and mail it with this form to listed address below.
Check Number: _______________
Name:_______________________________________
Address:_____________________________________
____________________________________________
____________________________________________
Phone:_______________________________________
Signature:_______________________________________________
*Early Bird Fee postmarked Before July 10th
**Late Fee Due after July 24th.
Online Registration Closing Date:
Tuesday, August 3, 2010 @ 5:00 PM
5326 West Bellfort
Suite 102
Houston, TX 77035
Phone: 713-667-6460
Fax: 713-667-6470
E-mail: sahtourdautism@seanashleyhouse.org