Outreach Activities

Outreach Activities

Outreach Activities

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Registration Form

Six Flags Registration Form

One of your parents have been diagnosed with cancer

Your Last and First Name

Birth Date

Street Address

City

Region/State/Province

Postal / Zip code

if you are under age 16, please provide name of accompanying adult (Last and First name)

Are you bringing a friend?

Friend's Full Name and age

Will siblings attend?

Siblings Names and ages

Will siblings bring a friend?

Siblings' Friends' Names and ages

Will parent/s attend?

Parent/s Full Name/s

Contact Email

Phone

I have read and agree to the terms & conditions of the waiver

Got it! We will send you a confirmation e-mail after we receive the nomination letter.

Champions Against Cancer

Champions Against Cancer Inc. is a Howard County, Maryland-based 501(c)(3) charity registered with the state of Maryland. Champions Against cancer is established to provide financial support and resources to the children and families of those afflicted with cancer.

Email: championsagainstcancer@gmail.com

Phone: 301-509-5669

Mailing Address:
Champions Against Cancer
P.O. Box 115
Highland, Maryland 20777

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