PEPP On-Site Registration

ON-SITE REGISTRATION

Name

First Last

Team

Email

What method are you paying with?

Credit Card

Cash/Check

T-Shirt

Price: $40.00

T-Shirt Sizes

Please list sizes separated by a comma (if applicable). Size options: XS, S, M, L, XXL, XXXL

Cash/Check

Please fill out the amount you would like to pay with cash or check.

T-Shirt Sizes

Please list sizes separated by a comma (if applicable). Size options: XS, S, M, L, XXL, XXXL

Would you like to make a donation?

Yes

No

Donation Amount

Please fill out the amount you would like to donate to Desert Cancer Foundation.

Total

Credit Card

Address

42600 Cook Street, Suite 203

Palm Desert, CA 92211

Contact Information

Telephone: (760) 773-6554

Fax: (760) 773-6532

Social Media

Address

42600 Cook Street, Suite 203

Palm Desert, CA 92211

Social Media