2018 Truck Convoy for Special Olympics Registration Form 2018 Truck Convoy for Special Olympics Company InformationI, or my company, wish to participate as* Guardian Sponsor - $10,000 (no limit to # of trucks) Gold Sponsor - $6,000 (no limit to # of trucks) Silver Sponsor - $3,000 (30 trucks maximum) Bronze Sponsor - $1,000 (10 trucks maximum) Convoy Participant - $100 (1 truck) Private Donation Private Donation Amount (if applicable)Number of Trucks?Guardian: unlimited // Gold: unlimited // Silver: 30 max // Bronze: 10 max // Participant: 1Total Amount DueRegistration/Sponsorship + Cost of any ride along t-shirts (Ride along T-shirts: $10 each)Ride along t-shirt sizes ($10 each)XSSMLXLXXLXXXLCompany Name*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Company Contact Name First Last Company Phone NumberCompany Email Payment Method*For check payments, please mail to Special Olympics North Carolina c/o Truck Convoy at 2200 Gateway Centre Blvd., Ste. 201, Morrisville, NC 27560 Cash (please contact Ruth Lee at 919.741.3617) Check (make payable to Special Olympics North Carolina) Credit Card (please contact Ruth Lee at 919.741.3617) Driver Information**Each driver must present proof of insurance, registration, and a valid CDL at check-in on October 20**Select all that apply* Select All I have the minimum insurance limits required by the state I have a Commercial Driver's License I have a minimum of $1,000,000 combined single limit insurance for my vehicle Upload proof of insurance or email to Ruth Lee (rlee@sonc.net)Driver Name First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Driver Cell PhoneDriver Email T-shirt SizeXSSMLXLXXLXXLFull Name(By printing my name below, I certify that the information provided on this form is true and accurate to the best of my knowledge and I am agreeing to allow Special Olympics use of all event-related photography and video for marketing needs.)