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Make-A-Wish Challenge Form



















Thank you for your interest in participating in the Make-A-Wish Challenge to help raise money for local WNY wish children like Selena Rose.

selenarosephoto.jpg
Selena Rose, WNY Wish Child

Please fill out the form below to register for the Challenge. Registration packets will be available at the kick-off party April 2 from 2-4pm at the Market St. Art Studios or by mail if you are not able to attend the kick-off party.

Full Name:
E-Mail Address:
Address:
City:
State:
Zip Code:
Phone Number:
Will you be attending the kick-off party?Yes
No
Are you interested in selling the $10 raffle tickets?Yes
No
Questions or Comments:
  

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