Fundraiser Donation - Registration Form

First Name:

Last Name:

Street Address:




Home Phone:

Area Code

First 3 digits

Last 4 digits

Email 1:

Email 2:


Fund Selection:

By checking this box, I understand that this payment is nonrefundable after 96 hours of making an online payment. There are no exceptions regardless of reason or circumstance. I have also read the Payment and Privacy policy.

Click here to read our policy.

Please note that you will recieve two emails. The first email is a registration confirmation email. The second email is a payment confirmation email. If you do not recieve the second email, you are not properly registered.