2002

ON-LINE REGISTRATION IS NOW CLOSED
PLEASE REGISTER ON DAY OF WALK!

1. Registrant Information
This entry is for Annie's Angels Individual Entry Other Team (specify Below)
Mr. Mrs. Ms.
First Name: Middle Initial:
Last Name:
Street Address: City
State: Zip:
Home Phone: Work Phone:
Email: Date Of Birth
Male Female

2. Provide Company, Team, and Fundraising Goal Information:

Company/Organization: Team:
Fundraising Goal $: Captain:

Yes, I want to be a Team Captain, send me more info!

My Company Matches Gifts: Yes No
I plan on
turning in $100 on or before the day of the event to receive my T-shirt
Yes No
My T-Shirt size is: small medium large xl
3. Choose Walk Location and Distance:
I will walk in: Bridgeport Fairfield Litchfield New Milford
I want to walk: 2 Miles 5 Miles 8 miles

ON-LINE REGISTRATION IS NOW CLOSED
PLEASE REGISTER ON DAY OF WALK!