I am interested in Over The Rainbow Special Needs Riding Program.

I would like to participate as a rider:

Name:__________________________________

Address:_______________________________

Phone:_________________________________

I would like to volunteer:  I can

	[ ]  Help the riders

	[ ]  Help with special projects

	[ ]  Help with fundraising
	
	[ ]  Other:____________________

Name:__________________________________

Phone:_________________________________



Enclosed is my tax-deductible contribution of $______________

(Over The Rainbow, Inc. is a 501(c)(3) non-profit organization.)

Name:__________________________________

Address:_______________________________

_______________________________________


Make checks payable to:

	Over the Rainbow, Inc.
	92611 Airport Rd
	Sixes, OR 97476




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