Relay for Life Request Form

Relay for Life Request Form

Please complete attached form and email it for requests, or print it out and send to the address listed at the bottom. Thanks for your interest in joining in our fight against cancer.

Your Name:

Company Name:

Email Address:

Address:

City:

State or Province:

Country:

Zip Code:

Phone Number:

Comments:

I would like to:

Receive more information on how to form a team.
Receive information about becoming a sponsor.
Learn how I can help volunteer.
Make a donation (enclosed) of $_____________. *

Name:_________________________________________
Message:_______________________________________
Enclosed is my donation of: $_______ *

Please mail donations to:

WATAUGA COUNTY RELAY FOR LIFE
c/o Glenda Trivette
7143 US Hwy 421 N.
Vilas, NC 28692

A portion of your donation may be tax deductible.

Your Name:
Company Name:
Email Address:
Address:
City:
State or Province:
Country:
Zip Code:
Phone Number:
Comments:
I would like to:
Receive more information on how to form a team. Receive information about becoming a sponsor. Learn how I can help volunteer. Make a donation (enclosed) of $_____________. * Name:_________________________________________ Message:_______________________________________ Enclosed is my donation of: $_______ *