| Relay For Life American Cancer Society A Team Event to Fight Cancer 1. 2. 3. 4. 5. Luminaria Order Form Relay for Life of Ripley County Batesville High School, June 17-18, 2006 As part of the Relay For Life of Ripley County, we are extending to you the opportunity to purchase an honorarium luminaria to be placed around the track on the evening of the event. The Luminaria Ceremony is a special time during the Relay to honor those who have survived cancer and remember those who have touched our lives. The name of your loved one will be written on the outside of the luminaria bag and placed around the track. The luminaria are then lit to help us remember what Relay For Life is about... cancer and its victims. The ceremony begins at 9:00 pm. You may purchase a luminaria bag for $5 each, with all of the proceeds going to the American Cancer Society Relay For Life. Please send a check, made payable to the American Cancer Society, along with the bottom portion of this form to the following address: American Cancer Society Relay for Life Ripley County 378 Coonhunters Rd. Batesville, IN 47006 In Honor Of In Memory Of 1. 2. 3. 4. 5. Amount Enclosed $________ ($5 per luminaria) (Check payable to the American Cancer Society) Your Name: Address: Phone #: ( ) City/State/Zip: Reminder: Please print legibly the names of those remembered and include the payment of $5 for each name you have listed above. The deadline for 3058808 Total number of luminaria being purchased ________ mailing is June 9th. |
