Team Registration

REGISTER HERE AS A TEAM
Please submit only one Registration Form per team

* Indicates required field

TEAM NAME *

Do all team members give permission to have the name of your team posted on the 100 Women Who Care Lennox & Addington website and across our social media platforms? *

YES NO

Team Member #1 *

Team Member #2 *

Team Member #3 (if applicable) *

Team Member #4 (if applicable) *

NOTE: We ask that one member donate on behalf of a team in order to ease the administrative burden. The person that writes the cheque or donates cash will be issued the tax receipt.

Please check each box below to agree to the following statements: *

We understand that we are making a commitment to 100 Women Who Care Lennox & Addington County for a minimum of one year (four meetings) and until we complete an Opt Out Form. We agree to fulfill our donation commitment even if we did not vote for the charity selected by majority vote. If no one from our team is able to attend a quarterly meeting, we will provide our cheque to another member to deliver in our place or courier or deliver our donation in person to 100 Women Lennox & Addington c/o Napanee Opticians, 118 John Street, Napanee, ON, K7R 1R2. We give permission to Jen Fitzpatrick of Serendipity Studios and 100 Women Who Care Lennox & Addington County to use photos that we are in for web content, advertising, etc. We understand that our team name will only be used in conjunction with our photo if our submitted charity is drawn and/or is successfully selected.

Team Member #1

Name *

First

Last

Phone Number *

Email *

Do you give permission to The Leading Ladies to contact you about 100 Women Who Care Lennox & Addington County via email? *

YES NO

Address *

Line 1

Line 2

City

State

Zip Code

Country

Team Member #2

Name *

First

Last

Phone Number *

Email *

Do you give permission to The Leading Ladies to contact you about 100 Women Who Care Lennox & Addington County via email? *

YES NO

Address *

Line 1

Line 2

City

State

Zip Code

Country

Team Member #3 (if applicable)

Name *

First

Last

Phone Number *

Email *

Do you give permission to The Leading Ladies to contact you about 100 Women Who Care Lennox & Addington County via email? *

YES NO

Address *

Line 1

Line 2

City

State

Zip Code

Country

Team Member #4 (if applicable)

Name *

First

Last

Phone Number *

Email *

Do you give permission to The Leading Ladies to contact you about 100 Women Who Care Lennox & Addington County via email? *

YES NO

Address *

Line 1

Line 2

City

State

Zip Code

Country

Submit

REGISTER HERE AS A TEAM
Please submit only one Registration Form per team

Team Member #1

Team Member #2

Team Member #3 (if applicable)

Team Member #4 (if applicable)

Our 12th meeting is on wednesday, March 20th 2019
at Lafarge Banquet Hall @ Strathcona Paper Centre, Napanee
Meeting: 7:30-8:30pm

CONTACT US

Frequently Asked Questions

OTHER CANADIAN CHAPTERS

REGISTER HERE AS A TEAMPlease submit only one Registration Form per team

Team Member #1

Team Member #2

Team Member #3 (if applicable)

Team Member #4 (if applicable)

Our 12th meeting is on wednesday, March 20th 2019at Lafarge Banquet Hall @ Strathcona Paper Centre, NapaneeMeeting: 7:30-8:30pm

CONTACT US

Frequently Asked Questions

OTHER CANADIAN CHAPTERS

REGISTER HERE AS A TEAM
Please submit only one Registration Form per team

Our 12th meeting is on wednesday, March 20th 2019
at Lafarge Banquet Hall @ Strathcona Paper Centre, Napanee
Meeting: 7:30-8:30pm