Buddy Walk 2011 Team Registration Form

Submission Deadline October 15, 2011

 

Team Information

Please tell us about your Buddy Walk Team:

Business/Organization Name

Team Name

Buddy Name

The name of your teams Buddy (if you are walking in honor of someone with DS)

Team Members

The estimated number of members in your team.

Team Captain Name

 

Buddy Walk T-Shirts

Sizes & Quantity

Please select the size and quantity of Buddy Walk T-Shirts you will need for your team:

Youth


Qty:
Small
Med
Large

Adult


Qty:
Small
Med
Large

 


Qty:
XL
X2
X3

Toddler


Qty:
2T
4T
6T

Onesies



Qty:
0-6 Months
6-12 Months

Contact Information

Please provide your team captains contact information:

Street Address

City

State

Zip Code

Phone Numbers

Please tell us about the best way to reach your Team Captain by phone. GCDSS will not share or sell your phone numbers with anyone....ever.

Captain Home Phone

Captain Cell Phone

Alternate Phone

Please designate a substitute captain in the event that the captain is unable to attend:

Substitue Captain Name

Substitute Captain Phone

Email Address

Please provide an email address for the team captain

Email Address

Email (Verify)

Questions?

If you have questions

Should you have any questions, please contact Kim Duffy at (228) 623-3331 or Cindy Hansen at (228) 323-7654 or via e-Mail at gcdss@cableone.net.