Memorial Show Participation

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The mark, American Cancer Society, is a registered trademark of the American Cancer Society, Inc., and may not be copied, reproduced, transmitted, displayed, performed, distributed, sublicensed, altered, stored for subsequent use or otherwise used in whole or in part in any manner without ACS's prior written consent.

As part of our TEAM Relay for Life, each year we hold a Memorial Show with the proceeds donated to the American Cancer Society Relay For Life and you can read more about this show and what we have done by Checking our Events page and the Charities on the Membership page. We have been very successful in our fund raising efforts and now we want to extend the opportunity to others to participate with us.

We have "opened" the back of our show t-shirt to anyone who would like to submit a name of a person who is a Cancer Survivor, to Celebrate a Cancer patient or to Honor a Cancer patient, in addition to other sponsors.

These names will appear in an individual framed section with the persons name and the words Survivor, Celebration or in Honor.

The cost is $25 for each name submitted. You can pay via PayPal or check.

THIS IS NOT YOUR REGISTRATION FEE

Pay via  PAYPAL

Select one

FOR ALL OTHER PAYMENT - Complete the information below, print it using your browser printer, and mail along with a check to the address below.

What type participation? Click one

SURVIVOR CELEBRATION HONOR IN MEMORY

What NAME do you want us to use?

NAME:

Tell us how to get in touch with you:

Contact Name
E-mail
Tel

 

MAIL TO: FALLS CITY MUSTANG CLUB / P O BOX 654/ JEFFERSONVILLE IN 47130