Walk to Remember — Registration Form

Print this page, complete it, and mail or fax it to the address below.

Print Registration Form

Saturday, October 11, 2003 at 2:00 PM
1st Baptist Church South, Tyler
Registration begins at 1:00 PM.

Child(ren)'s Name(s) to Remember

To have your child(ren)'s name(s) included on the remembrance t-shirts, registration and payment must be received by September 26, 2003.

Child's Name: _________________________

Child's Name: _________________________

Child's Name: _________________________

T-Shirt Order

T-shirts are $12.50 (adult) and $7.50 (child).

Adult T-shirts: ___    Child T-shirts: ___

Your Information

Name: _________________________________

Address: ______________________________

City: ______________ State: ______________ Zip: ______________

Phone Number: ______________ Email: ______________

Mail or Fax Your Registration

Children Are A Gift / Remembrance Walk
4828 S. Broadway #122
Tyler, TX 75703

Phone & Fax: 903-939-1597

Questions: traci@childrenareagift.com

Admission to the Walk is free. For more information, visit the Walk to Remember page.