On-line Registration Form

Saturday, October 22
Teague Park - Longview
 

Registration begins at 9:00 a.m. with the one-mile walk at approximately 10:30 a.m. Take Hwy. 80 to National Armory Rd. (across from Super 1 Foods), and turn south.
 
 
of East Texas
 
Name(s)
Separate multiple names using a comma (,)
Total # of
Walkers
Street
Address
City State   Zip
Phone #


Yes! I will be there to Support the WALK.

Individual Registration - $15 (includes 1 shirt)
Family Registration - $40 (includes 3 shirts)

Additional Family members and/or shirts - $10


REGISTER BY OCTOBER 9th TO GUARANTEE A T-SHIRT

T-shirt size(s): Please mark size(s) of shirt needed by indicating the number for each size:
Youth
2/4 6/8 10/12
Adult
S M L XL XXL
 
I want to be a SUPER BUDDY WALKER! Donate $50 or more, above and beyond the registration fee. Please accept my personal contribution of: $
I cannot participate in the walk, but please accept my tax deductible contribution of: $
** Required: In consideration of me and/or my minor child being permitted to participate in the Buddy Walk of East Texas, I hereby, for myself, my heirs and personal representatives assume any and all risks which might be associated with the event. I further waive, release, discharge and covenant not to sue the East Texas Down Syndrome Group, its sponsors, organizers, volunteers or other representatives or their successors and assigns, for any and all injuries or damages of any kind whatsoever suffered by myself and/or my minor child as a result of taking part in the event and any related activity. I also authorize the use by the National Down Syndrome Society and/or East Texas Down Syndrome Group of any photo, film or videotape taken of me or my minor child at the event for any purpose.

East Texas Down Syndrome Group (ETDSG) filed for a 501 (c)(3) classification with the IRS in August 2003. On November 13, 2003 we were granted a 509 (a)(1) classification that is effective during an advance-ruling period ending December 31, 2007. The 501 (c) (3) classification can be obtained thereafter. All contributions to ETDSG are tax deductible. Our Employer Identification Number is 71-0908666. Our Texas Sales or Use Tax Permit Number is 17109086664.