Champions of Hope Registration

Date: September 13, 2011 at 5:30 PM
Please RSVP by September 5, 2011. Payment must be received before registration will be processed. Tables seat 8 - 10 people at $65 per person. (Cost of goods received is $30 per person.)

Name: *

Address:

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Number of seats: *

Please select number of reservations you will be paying for at this time.

I am unable to attend. My donation is: $

Champions of Hope Bouquet ($25 per honoree)

A beautiful tribute bouquet will be displayed at the event to honor loved ones who have battled cancer.

Dedication Type:

In memory of

In honor of

Tribute Name:

Additional Tributes - please complete the comments box at the bottom of the page.

Please notify

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Address:

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ST:

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Attendees

1. Name(s):

2. Name(s):

3. Name(s):

4. Name(s):

5. Name(s):

Comments:

Our Mission

To raise financial support and cultivate the community's legacy of leadership, enhancing the Margin of Excellence of providing the region's best health resources, delivered with a human touch.

Our Vision

Making a difference by joining a legacy of leadership to help assure the region's best comprehensive and specialty health resources are delivered with a human touch to benefit the entire community.