Cancer Services of Grant County

Team Name

If your team is not listed, scroll to the bottom of the list and select "other" and type your team name.

If this is a new team, are you registering as Team Captain?

Yes

No

This is not a new team.

* Name - Walker #1

* #1 - Virtual Walker or Angel?

#1 - Purchase Cancer Services Event T-Shirt?

Name - Walker #2

#2 - Virtual Walker or Angel?

#2 - Purchase Cancer Services Event T-Shirt?

Name - Walker #3

#3 - Virtual Walker or Angel?

#3 - Purchase Cancer Services Event T-Shirt?

Name - Walker #4

#4 - Virtual Walker or Angel?

#4 - Purchase Cancer Services Event T-Shirt?

Name - Walker #5

#5 - Virtual Walker or Angel?

#5 - Purchase Cancer Services Event T-Shirt?

Name - Walker #6

#6 - Virtual Walker or Angel?

#6 - Purchase Cancer Services Event T-Shirt?

Name - Walker #7

#7 - Virtual Walker or Angel?

#7 - Purchase Cancer Services Event Shirt?

Name - Walker #8

#8 - Virtual Walker or Angel?

#8 - Purchase Cancer Services Event T-Shirt?

Please check all walkers from above (excluding angels) who have ever been diagnosed with cancer.

#1

#2

#3

#4

#5

#6

#7

#8

* Name

* Address

* City

* State

* Zip Code

* Email

Phone

Would you like your shirts or survivor bib shipped to you?

Help cover credit card costs by donating $1 or make an additional donation to help people facing cancer in Grant County?

Would you like to create a fundraising campaign?

Yes

No

* Campaign name

* Goal

Payment Information

Total:

Walk of Hope

Payment Information