Early Registration Options: Closed
Complete and submit registration form below OR:
1. Complete form, PRINT and mail to:
Radiant Life Church
12022 Mansfield Road
Keithville, LA. 71047
2. Contact the church office at (318) 925-0907
3. Copy and e-mail completed form to jkradiantlife@aol.com
*Registration for the Run For Freedom is $20.00* (If you are pre-registered and purchase a raffle ticket for the Sportster, the reduced cost is $35.00.)


Rolling Radiant Thunder 2008 Registration
Last Name
 First Name
 Male
Female
Street Address
  
City
 State
 Zip
Phone Number (include area)
 Cell Phone (include area)
Email Address
Club Affiliation
How did you hear about us?

Early Registration is now closed. See you at the Rally!

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