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  Support Us

PRINT THIS FORM, FILL IT OUT AND MAIL, WITH YOUR CHECK OR MONEY ORDER TO THE ADDRESS LISTED BELOW.

If you can't join us, but would still like to participate, we would appreciate your donation.

Our fund raising efforts start early in February each year; and include bake sales and other on-site activities to raise funds to pay for walker's services, safety and medical supplies, and other necessities. We use any "left-over" funds to help support needy Death Valley cancer patients.
     
   
WALKER SUPPORT: transportation, food, water, first aid, camp site registration/fees, etc.
DIRECT TO CANCER PATIENT SUPPORT
OTHER:
   
    SELECT AMOUNT : $10 $20 $40 $60 $100 Other
     
    Any additional information or comments:
   
   
   
     
 
  Donor Information
Required items are marked with an *    

* First Name:

   
* Last Name:
   
* Address:
    
Address 2:
   
* City:
    
* State/Province:
    
* Zip/Postal Code:
   
* Country:
    
E-Mail Address:
    A receipt for your donation will be sent to this email address.
Daytime Phone:
   
         
 
Payment Information
  PRINT this form and send it, along with your check or money order to:
   
   
   
Life Walk Registration
   
ATTN: Sharon Funck
   
PO Box 578
Death Valley, CA 92328
       
         
© 2007-2011 Death Valley Walk for Life    
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