MEMORIAL & HONORARY TORCH FORM
 RELAY FOR LIFE 2017
Watauga High School
Friday June 16th 
A fund raiser of the American Cancer Society’s 
Relay For Life of Watauga County

Memorial torches light up the night! Torches with honorees’ names prominently displayed on memorial cards and decorated with a large purple bow will provide a glowing inspiration throughout the night as they are lit in a special area set aside to display these beacons of hope. These Lights of Love allow us to pay tribute to the memory of our loved ones who have lost their battle with cancer and to honor those who continue their fight.

Please fill out the form below and enclose $100 for each torch purchased. Make your check payable to the American Cancer Society for the total amount due. Your cancelled check will serve as a receipt for your tax-deductible contribution. Thank you for joining in our fight against cancer.  Hope begins with you.
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Your Name	________________________________________		 	 Amount Enclosed          

												$________________
	Address	________________________________________
			________________________________________

	Phone		________________________________________

PLEASE PRINT NAMES BELOW:				If you would like an acknowledgment sent to a family member, please print their name and address
Memorial torch purchased 
in Memory of

 ______________________________			_________________________________________
								__________________________________________
								__________________________________________				
Honor torch purchased 			
in Honor of							________________________________________
								__________________________________________
_______________________________			__________________________________________

__________________________________________________________________________________________

						Team Member: ____________________________________________	

						Team Name: ___________________________________	 				

Send form with contribution to:

Relay For Life of Watauga County
American Cancer Society
4A Oak Branch Dr
Greensboro, NC 27407

It’s about being a community that takes up the fight......