Relay for Life 2009                                    

    LUMINARY                  

 

               For the Person County Unit of the American Cancer Society

                                       September 25, 2009
                              Person High School

 

For a MINIMUM DONATION OF $10 your luminary will shine all
night at the 2009 Relay for Life in honor of, in memory of, or in
prayer for someone close to you.
              
Deadline August 27, 2009 to appear in program

 

            Make checks payable to the American Cancer Society.

            Return this form and your donation to a Team Captain or to

                                    P.O. Box 165, Roxboro  27573 

Check One (required):

       _____       MEMORY
       _____      
HONOR
       _____       PRAYER

 (Only one name per luminary.)

Honoree’s name as it should appear on the luminary bag:

 _______________________________________________________________________

  Your name as it should appear on the luminary bag:

 ________________________________________________________________________

 Please use a new sheet for additional luminaries.

Your Phone (required): ___________________________________________________

TEAM Name (if applicable): _______________________________________________

Amount enclosed:  $____________