2018 School Climb for Cancer
1.
Name of Teacher/Champion/Main Contact:
*
Title:
Mr.
Ms.
Mrs.
Miss
Dr.
Required
*
First Name:
Required
*
Last Name:
Required
*
Email:
Required
*
Phone Number:
Required
Yes, I would like to receive email from Hamilton Health Sciences Foundation
*
2.
Question - Required -
Name of School:
(Maximum response 255 chars, approx. 5 rows of text)
3.
Question - Not Required -
Team Name (Optional):
*
4.
Question - Required -
Number of Students Attending:
*
5.
Question - Required -
Desired Climb Time:
9:00am
10:30am
12:00pm
1:30pm
Spam Control Text:
Please leave this field empty
