Register Your Event!

Submit this registration form with details of your event and we will post it on this web page and on our Facebook page.

Proceeds and photographs will be posted after your event, so be sure and take some exciting pictures for us to share with others.

*	Name of Organization
*	Name of Event
*	Type of Events (walk, golf tournament, etc.)

Once you are registered, if you wish to use Spread the Wave To Cure Cancer in the name of your event, you may use the Spread the Wave To Cure Cancer logo, which we can provide on request. We suggest “Proceeds of this event will be donated to the John Kanzius Cancer Research Foundation” as the best way to publicize your connection. Please don’t use John Kanzius or the Foundation name or logo in the title of your event as we reserve them for our sponsored events.

How will the funds be raised?

* % of funds to be donated to the Foundation

(Your event will be listed on our website if the Foundation is the sole beneficiary.)

* Dates and Times of Event

* Location of Event

* Would you like the logo for Spread the Wave To Cure Cancer (be sure to include e-mail contact)?
Yes No

* Would you like a representative from the Foundation present at the event or following it to receive the funds and for a photograph? Yes No

(Availability will be determined by proximity to Erie, PA as Foundation representatives are volunteers.)

Event Contact Information:

*	Name of Contact
*	Address
*	City
*	State
*	Zip
*	Phone Number
*	Email
	Website for more information