Walk-A-Thon Registration

Walk-A-Thon Registration

Thank you for your desire to join us for our Annual Walk-A-Thon on March 27, 2010!
The fun will begin at 8am with music, continental breakfast, games and check-in.

* Required fields
Name *
E-mail Address *
Phone Number *
Street Address *
City *
State *
Zip Code *
Choose Your Location *	Freedom Park, Charlotte I will walk on my own
I will *	Raise Sponsorship to Walk Donate to Walk
If part of a team, who is your team leader?
Please select your t-shirt size *	small medium large x-large xx-large
How did you hear about the Walkathon?	Church Mail E-Mail Friend Newspaper or other publication Radio Our Web Site Other
	I agree, as a condition of my participation in the Lois’ Lodge Make A Difference Walk For Life, not to file a claim, complaint, or suit of any kind against the ministry, Board of Directors, or staff, for negligence or any other reason, arising from or during my participation in this event. I do hereby release, by checking this agreement, the Lois' Lodge Board of Directors and staff from any such claim, complain or suit. *

I have read and agree to the Privacy Policy *

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If you desire to be a walker but are unable to raise sponsors, please consider making a personal donation to walk. You can mail your donation to Lois' Lodge or visit our donate online page to pay with your debit or credit card. The Lois' Lodge Walkathon is a major fundraising event for the ministry and we appreciate your support.

You can join in the work of Lois' Lodge through a one time gift
or by providing ongoing monthly support.: http://www.loislodge.org/donate.html

Debbie Durrell, Executive Director

Lois' Lodge * 1316 Hemlock Street * Charlotte, NC 28203
(704)376-8550

http://www.loislodge.blogspot.com/