2012 Registration by kroulhac


									                                       Third Annual
                                    Daughters on the Move
                                 “One More Tomorrow”
                                      Sponsored Walk
                                        June 3, 2012

Yes, I would like to participate in the Daughters on the Move “One More Tomorrow” sponsored
walk, on Sunday, June 3, 2012 at Franklin Park in Boston, Massachusetts.

                                 CONTACT AND ADDRESS INFORMATION

              Registration fees to participate in the sponsored walk are as follows:
 Please check one:      $20.00 - 18+       $15.00 - 65 +      $10.00 - 6-17 yrs.         No Fee - 0-5 yrs.

Name __________________________________ Phone ___________________ Email _______________


City ____________________________________ State _______________________ Zip ____________

       Check enclosed payable to: Church of God and Saints of Christ - Memo: One More Tomorrow
                                                                             What is the CSC Number?
       MasterCard         Visa         American Express         Cash         (For Master Card & Visa the (3) digits in
                                                                             the signature area on the back of your
                                                                             card. For American Express the (4) digits
                                                                             that appear on the front of your card.)

Card Number _____________________________Exp. Date ________________CSC Number ________

Cardholder Name ______________________________________________________________________

Total Amount $ ________________________ your gift is tax-deductible to the extent permitted by law.

                  (Your registration will include one free t-shirt and walking number)

              For more information, please contact Rachel Jones at (857) 364-7199 or visit
                             Please return this form with payment to:
                                        Daughters on the Move
                              P.O. Box, 180-488, Boston, MA 02118

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