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  • Als Registration Form

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    Lesley Elsberry Mills
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    This registration form is for a 1-mile walk being held on September 14, 2013 in Paris, Illinois to support the "Pulling for ALS Walk." Participants can register between 9-10am at the West Lake Pavilion, with the walk starting at 10am. The form requests the registrant's contact information and t-shirt size, with a $20 registration fee per person to receive a t-shirt. Completed forms and payment must be mailed to the contacts listed by September 1st to guarantee a t-shirt size.

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    This registration form is for a 1-mile walk being held on September 14, 2013 in Paris, Illinois to support the "Pulling for ALS Walk." Participants can register between 9-10am at the West Lake Pavilion, with the walk starting at 10am. The form requests the registrant's contact information and t-shirt size, with a $20 registration fee per person to receive a t-shirt. Completed forms and payment must be mailed to the contacts listed by September 1st to guarantee a t-shirt size.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    22 views1 page

    Als Registration Form

    Uploaded by

    Lesley Elsberry Mills
    This registration form is for a 1-mile walk being held on September 14, 2013 in Paris, Illinois to support the "Pulling for ALS Walk." Participants can register between 9-10am at the West Lake Pavilion, with the walk starting at 10am. The form requests the registrant's contact information and t-shirt size, with a $20 registration fee per person to receive a t-shirt. Completed forms and payment must be mailed to the contacts listed by September 1st to guarantee a t-shirt size.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    REGISTRATION FORM

    Support the

    2013 Pulling for ALS Walk


    *Saturday, September 14, 2013

    *1 mile walk beginning at the West Lake Pavilion in Paris, IL


    *Registration begins @ 9:00am Walk begins @ 10:00am
    Name:_________________________________________________________________________
    Address: _____________________________________________________________________________
    City: _________________________________ State: ________ Zip: ______________________________
    Phone: ________________________________

    Email Address: _______________________________

    $20 per person/tshirt


    Choose T-shirt size:
    YS___ YM____ YL _____
    AS___AM ____AL ____AXL____AXL ___ A2XL _____A3XL____
    Enclosed is my check in the sum of $___________

    Please make check(s) payable to: Pulling for ALS


    st

    Forms and money must be turned in by September 1 for t-shirt guarantee.

    Please mail this form and your check(s) to:


    Lesley Mills
    2 Drue Drive
    Paris, IL 61944
    217-251-6366
    lesley.mills83@gmail.com

    or

    Josh Elsberry
    14906 N 2225th ST
    Paris, IL 61944
    812-208-5049
    josh_elsberry@yahoo.com

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