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Over the Edge
Registration Form

Special Olympics Louisiana
1000 E Morris Ave
Hammond LA 70403
985-345-6644 phone
800-345-6644 toll free
985-345-6649 fax

Baton Rouge New Orleans

Sat., November 21, 2009 Tues., November 24, 2009

Louisiana State University, Tiger Stadium Best Western Landmark Hotel

Stadium Road 2601 Severn Avenue
Baton Rouge, LA 70803 Metairie, LA 70002

Which location and date would you like to participate in?:

Baton Rouge, LA on 11-21-09
New Orleans, LA on 11-24-09

Name

Company

Address

City

State

Zip

Phone

Email Address

Options:

  I would like to go Over the Edge.
  I will be unable to attend, but would like to make a donation.
  I cannot attend but would like an athlete go Over the Edge instead.
  I am interested in possible sponsorship packages for my company.

Please make checks payable to Special Olympics Louisiana.

Mail check to:

Special Olympics Louisiana
Over the Edge Event
1000 E Morris Ave
Hammond LA 70403

I will pay by check

To pay by credit card please call our office:
985-345-6644 or
800-345-6644 Save

I will pay by credit card

I am currently still raising funds but want to reserve my place.

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