Tippecanoe County Right to Life, Inc.

Date
Saturday, May 21^st, 2022

Time
Registration at 10:30 a.m.

Kick stands up at 12pm

Picnic at 2pm

Address
Mount Hope Church
1718 N. 15^th Street
Lafayette, IN 47904

Picnic and T-Shirt Included with Registration

$ 20

Riders: Single

$ 30

Riders: Couple

$ 10

Picnic Only

Total amount: $0.00 (U.S. Currency)

Please list the name(s) of the rider(s) or picnic attendees:

500 characters left

Payment Options *

Credit Card or Check/Debit Card

Bank Account Transfer (ACH)

Card Number

Security Code (CVV2)

Expiration Date

YES! Please add 3% to my payment to help offset the Processing Fees assessed to Tippecanoe County Right to Life.

Account Type(U.S. Banks Only)

Routing Number

Account Number

YES! Please add $0.25 to my payment to help offset the Processing Fees assessed to Tippecanoe County Right to Life.

Your Information

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All payments provided to Tippecanoe County Right to Life, Inc. comply with U.S. laws and regulations.