DSSRI Buddy Walk®

September 14, 2014

10 am T-shirt pickup/ light breakfast snacks

11 am Walk

Activities & lunch immediately following walk

PLEASE NOTE: T-shirt sizes cannot be guaranteed at this point...but we will do our best!!

Registration Form

Family Name *

Address *

City *

State *

Zip *

Phone *

Email Address *

Optional Donation

Registration/T-shirt Sizes Children 12 and under $ 5.00 All others $10.00 Please enter quantity needed. Family member with Down syndrome is free to register. In the box below, simply enter that person's name and t-shirt size needed. DO NOT enter the t-shirt size in the above list or a fee will be assessed.

	2 T
	3 T
	4 T
	Youth S
	Youth M
	Youth L
	Adult S
	Adult M
	Adult L
	Adult XL
	Adult 2XL

Please enter name of family member with Down syndrome and t-shirt size needed. Thank You!! *