Benefiting Ovarian Awareness of Kentucky’s (O.A.K.) community Ovarian Cancer educational initiatives Saturday, November 14, 2009 Registration begins at 7:30am Walk starts promptly at 9:00am Douglass Hills Gazebo Douglass Hills is adjacent to Crosby Middle School at Gatehouse Lane Louisville, KY 40243 Cost: $25 per person $15 student cost (11 to 18 years old) Free for gynecological cancer survivors (please still register) and children 10 years old and younger. Pre-Register at www.ovarianawarenessofky.org or contact OAK Office at 502-708-1625 or info@ovarianawarenessofky.org This walk is proudly sponsored by the City of Douglass Hills. Registration Form Cost: $25 per person-General Admission $15 student cost (11 to 18 years old) Free for gynecological cancer survivors (please still register & note t-shirt size) Free for children 10 years old and younger (no need to register) **Great park setting! Be sure to bring your own chair or blanket.** o I would like to purchase ______ at $25 each, totaling $ _______. o I would like to sponsor ______ survivor(s) at $25 each, totaling $________. o I would like to reserve ______ complimentary passes (gynecological cancers only). Name ___________________ Type of Cancer__________ Year DX:__________ Circle T-Shirt Size: Small, Medium, Large, X-Large, 2X-Large Name ___________________ Type of Cancer__________ Year DX:__________ Circle T-Shirt Size: Small, Medium, Large, X-Large, 2X-Large Please PRINT names for those you are registering / purchasing for: 1.________________________ Circle T-Shirt Size: Small, Medium, Large, X-Large, 2X-Large 2.________________________ Circle T-Shirt Size: Small, Medium, Large, X-Large, 2X-Large 3.________________________ Circle T-Shirt Size: Small, Medium, Large, X-Large, 2X-Large 4.________________________ Circle T-Shirt Size: Small, Medium, Large, X-Large, 2X-Large Payment: Name: _________________________________________________________________ Street Address:_______________________City ___________ State_____ Zip________ Phone#______________________ Email______________________________________ o Enclosed is my check made payable to O.A.K. totaling, $______. o Contact me at the above number to pay via credit card, totaling $______. Available after November 5, 2009