2008 4-H DUCK RACE
DUCK CHANCE & 5K RACE ENTRY FORM

Name ___________________________________________________________________

Address _________________________________________________________________

City _____________________________________ State _____ Zip _________________

Phone______________________________ Email _________________________________

How did you hear about the Duck Race? __________________________________________

RUBBER DUCK RACE
I'd like chances on ______ ducks at $5 each, or a "flock" of 5/$20, for a total cost of $_______.
NOTE: Individuals must be 18 years of age or older to purchase duck chances.

FOOT RACE ENTRY
Enter me in the:
___ 5K "Waddleduck Phrolik" Road Race ($10 Advance, $20 day of race)............................. $_______
Gender: __M __F Age: ___ T-shirt size: ____ (free to 1st 50 entrants)

TOTAL: $________

[ ] I enclose my check for $____________ payable to "CCETC" with "duck race" written in
the memo line.
[ ] Please charge this order to my (circle one) VISA / MasterCard #_____________________

Exp. Date: ______. Your name as it appears on the card:______________________________

Daytime phone in case we need to call re: this charge: ________________________________

To charge your order by phone, call: (607) 272-2292.

Duck chance purchase forms will be accepted by mail until April 25, 2008, and in person until
1 p.m. on launch day. Please return this form to:

4-H Duck Race/CCETC
615 Willow Avenue
Ithaca, NY 14850