Eighth Annual Michael L. and Douglas A. Wivell Memorial Walk
 
WALKER REGISTRATION FORM  

 

Name(s)  (Please print clearly.)

1.

2.

3.

4.

5.

6.

7.

T-SHIRTS AVAILABLE AT THE WALK ON JUNE 14, 2008.  

Address:________________________________________________ 

        ________________________________________________ 

Phone:   ________________________________ 

Registration Donation:  ___________________

(Suggest $10 donation per walker.) 

Please make checks payable to:    Wivell Memorial Fund

 

Mail to:  

Wivell Memorial Fund

                   9511 Appolds Rd.
                    Rocky Ridge, MD  21778