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ROAD RALLY
REGISTRATION:



*SIGN UP FOR 2009 ROAD RALLY*

Congratulations- to "The Wenches" from Wayne Center

(Linda Griffin, Mary Sperry, Shannon Oliver, Christy Courtney-Wilson, Michelle Gallerini)

Plan to participate next year so that you too can have a chance with the traveling trophy

Thanks to everyone who participated...we were able to contribute $800 to Friends of CLS and we were able to contribute $200 to the Wayne County Autism Society and $200 to The Wayne Center Christmas Fund. We had 15 teams this year- lets increase to 20 (or more) teams next year- the more teams that we have, the more fun it is and the more we can donate to the worthy causes supported by the PsychSystems charitable fund.

Next year's theme- Cartoons!

The Road Rally raises funds for The PsychSystems Charitable Fund. This fund gives financial support to various groups who provide  assistance to people with disabilities and their families. Groups that we help include Friends of CLS, The Wayne County Autism Society, the Synergy Adopt a Family program and other deserving organizations. 

Instead of a "dinner" or "golf outing" (we eat too much already and we are lousy golfers) we have found that a Road Rally is a great way to have fun while raising money for good causes. If you have never done a Road Rally, don't worry, we will help you. If you have done one before, please help us recruit others- we can raise more money if we get more teams (and the after party is more fun as well). If you need more information, please call (734) 729-7792, ext 479 and speak to Dana Toth.

To register, please fill in the following information and hit "SUBMIT FORM" below.  Please pay your fee in one of the following ways:

<PayPal will let you pay your registration fee with a credit card.
OR you can also send a check to: PsychSystems P.C., 35640 Michigan Ave West, Wayne, MI 48184

Please Note: You are not registered until you have paid. We will not be able to collect at the Rally- Thanks for your help! COST is $20 per person (cheap-and goes to good causes!). This year your registration fee includes food at the final destination!

Please register your whole team on this form.  Pick a 'contact person' and put  their information on this registration so that we can contact them with additional information

IF YOU ARE AN INDIVIDUAL and want to register, please fill out the following information and put "Individual" in the box where we ask for "Name of Team"- we will put together teams from the individuals who enter.

Contact person Name

Name of Team (if you have one)

Organization

Work Phone

FAX

 Personal E-mail

Work Email

Please list
the members
of your team







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