If you wish to ONLY DONATE please click here for a simplified donation form.

SPONSORS please click here.

Your donation receipt will be mailed to the address you enter here.

If you have any questions during the donation or registration process, please click here to email Erica and Philip Barnes
Thanks!




REGISTRATION
Please enter your full name and address. Without a complete address we cannot send you a paper receipt as required by the IRS for you to be able to take your full tax deduction.
Name:

First Name :

Last Name :

Company:
only if registering as a company (please enter your name above, too)
Email:
Street:
 
City:
State: Postal:
please don't forget your POSTAL code
  Home Phone: Work/mobile Phone: Country:
Employer:
(optional)
Please apply for matching donations!
This information is used only to help facilitate matching gifts - your employer may double or triple your donation!

Registration details:
Early registration closed on 10/07/2011.
Donation due: $ 0
Adults running:
$ 30 ea
Adults walking:
$ 30 ea
Children:
$ 0 ea
Youth:
$ 15 ea
Extra t-shirts:
$ 15 ea if you want additional t-shirts please tell us here! (specify size below)

Please indicate total quantity of t-shirts by size
shirts left to select:
0

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Please select donation method:

   <-- Please make a selection.

  • PayPal is our credit/debit card payment partner (No user account at PayPal is required - after you get to the PayPal donation screen use the Pay With Debit or Credit Card link below the LogIn button)
  • The mailing address for checks is displayed on the next screen.


  Please correct error above  

100% of your donation will go to research - to support the work of Dr. Paul Orchard at the University of Minnesota and the Brains for Brain MLD Core research collaborative. Your donation to the MLD Foundation to support these two projects is fully tax deductable.



Please support the Sponsors who graciously support us!

_ Chloes Fight 2011 register edit no remote ignore 1020186