Ian's Rainbow Flu Foundation's Walking to Fight the Flu 2010

Join us on Saturday, October 16th for an afternoon of fun while helping to save children's lives!  Registration is $25 for the first walker and $5 for each additional family member.   Each registered walker will receive a t-shirt and lunch after walk.   Registered walkers age 6 months to 18 years may receive a free flu vaccine at the walk.   Register by Oct. 2rd to receive a t-shirt for each member of your team.  Join us after the walk for lunch and entertainment.   Proceeds will be used for flu education and to purchase flu vaccines for needy families. Please complete the form on the right to register for the walk.  You may make payment by PayPal or by personal check.

Participant Registration Form ($25.00) First Name: Last Name: Address: City: State: MO KS ZipCode: email: phone:                  Select Shirt Size: Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large Choose Payment Type:     PayPal        Personal Check If in doubt about shirt size, we recommend ordering one size larger. List Additional Walkers Below ($5.00 for each additional walker) Walker's Name Select Shirt Size Walker's Name Select Shirt Size Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large Please Pick Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Child Small Child Medium Child Large

If you encounter problems with this registration form, please contact us via email at webmaster@iansrainbow.org