SlideShare a Scribd company logo
American Cancer Society Relay For Life
                             Virtual Survivor Registration Form

  What is a Virtual Survivor? A Virtual Survivor is a person that has been diagnosed
  with cancer but cannot physically attend a Relay due to distance, time, illness, etc. These
  are the people in our lives that we CELEBRATE at Relay For Life, whether they can be with
  us at the event or not.

  How Does It Work? If you have a loved one who is unable to join us at Relay For
  Life, you can still pay tribute to them by creating a poster, photo, collage or t-shirt to honor
  them in the Caregivers’ Lap. You will be asked to join the lap with other Caregivers, carrying
  or displaying your tribute to your Survivor who could not be at the Relay.

  How do I sign-up? Register your Virtual Survivor by completing the form below and
  turning it in to your Relay’s Survivorship Chair or log on to your Relay’s website to register
  online.

  Why should I do this? Relay For Life is all about Celebrating Survivorship. We are all
  Relaying for someone special, through the Virtual Survivor program you can CELEBRATE
  the life of your loved one– even though they can’t be with you at the Relay. Plus, you will
  make them happy to know you are walking in their honor.

  Questions? Contact your Survivorship Chair for details!




  Relayer’s Name who will walk in their Survivor’s Honor:
  ________________________ Email: _________________________

  Relay Team Name: _________________________________________

  Virtual Survivor’s Name:______________________ Phone #: ___________________
  Address: _____________________________________________________________
  Email: _______________________________________________________________

  Cancer Type/Date of Diagnosis (optional):___________________________________

  Survivor’s T-Shirt Size:    S    M    L   XL    XXL

Please return to Kellee Albrecht at albrechk@friscoisd.org or fax to 972.687.7882.

More Related Content

Similar to Virtual Survivor Form

Survivor & Caregiver Registration Form
Survivor & Caregiver Registration FormSurvivor & Caregiver Registration Form
Survivor & Caregiver Registration Form
Frisco Rfl
 
January 2016 RSVP Messenger Newsletter
January 2016   RSVP Messenger NewsletterJanuary 2016   RSVP Messenger Newsletter
January 2016 RSVP Messenger Newsletter
RSVPVIP1
 
RELAY FOR LIFE
RELAY FOR LIFERELAY FOR LIFE
RELAY FOR LIFE
dandrew97
 
Lbcfsponsorform
LbcfsponsorformLbcfsponsorform
Lbcfsponsorform
natalie-oroark
 
VECProGuide2013
VECProGuide2013VECProGuide2013
VECProGuide2013
Catherine T. Revak
 
ReBirth Yourself Intro & Commitment - 2016
ReBirth Yourself Intro & Commitment - 2016ReBirth Yourself Intro & Commitment - 2016
ReBirth Yourself Intro & Commitment - 2016
Robin St.Clair
 
022309 Virtual Ability Metanomics Transcript
022309 Virtual Ability Metanomics Transcript022309 Virtual Ability Metanomics Transcript
022309 Virtual Ability Metanomics Transcript
Remedy Communications
 
July 2020 webinar slides
July 2020 webinar slidesJuly 2020 webinar slides
July 2020 webinar slides
Fight Colorectal Cancer
 
Apr 2014
Apr 2014Apr 2014
LIFE ElderCare Fall 2011 Newsletter
LIFE ElderCare Fall 2011 NewsletterLIFE ElderCare Fall 2011 Newsletter
LIFE ElderCare Fall 2011 Newsletter
LIFE ElderCare
 
Clarksburg Relay for Life 2012
Clarksburg Relay for Life 2012Clarksburg Relay for Life 2012
Clarksburg Relay for Life 2012
meghart
 
LIFE ElderCare Overview
LIFE ElderCare OverviewLIFE ElderCare Overview
LIFE ElderCare Overview
LIFE ElderCare
 
RSVP & VUB Conference presentation
RSVP & VUB Conference presentationRSVP & VUB Conference presentation
RSVP & VUB Conference presentation
Ellen Acevedo
 

Similar to Virtual Survivor Form (13)

Survivor & Caregiver Registration Form
Survivor & Caregiver Registration FormSurvivor & Caregiver Registration Form
Survivor & Caregiver Registration Form
 
January 2016 RSVP Messenger Newsletter
January 2016   RSVP Messenger NewsletterJanuary 2016   RSVP Messenger Newsletter
January 2016 RSVP Messenger Newsletter
 
RELAY FOR LIFE
RELAY FOR LIFERELAY FOR LIFE
RELAY FOR LIFE
 
Lbcfsponsorform
LbcfsponsorformLbcfsponsorform
Lbcfsponsorform
 
VECProGuide2013
VECProGuide2013VECProGuide2013
VECProGuide2013
 
ReBirth Yourself Intro & Commitment - 2016
ReBirth Yourself Intro & Commitment - 2016ReBirth Yourself Intro & Commitment - 2016
ReBirth Yourself Intro & Commitment - 2016
 
022309 Virtual Ability Metanomics Transcript
022309 Virtual Ability Metanomics Transcript022309 Virtual Ability Metanomics Transcript
022309 Virtual Ability Metanomics Transcript
 
July 2020 webinar slides
July 2020 webinar slidesJuly 2020 webinar slides
July 2020 webinar slides
 
Apr 2014
Apr 2014Apr 2014
Apr 2014
 
LIFE ElderCare Fall 2011 Newsletter
LIFE ElderCare Fall 2011 NewsletterLIFE ElderCare Fall 2011 Newsletter
LIFE ElderCare Fall 2011 Newsletter
 
Clarksburg Relay for Life 2012
Clarksburg Relay for Life 2012Clarksburg Relay for Life 2012
Clarksburg Relay for Life 2012
 
LIFE ElderCare Overview
LIFE ElderCare OverviewLIFE ElderCare Overview
LIFE ElderCare Overview
 
RSVP & VUB Conference presentation
RSVP & VUB Conference presentationRSVP & VUB Conference presentation
RSVP & VUB Conference presentation
 

More from Frisco Rfl

Fundraiser - Chili's
Fundraiser - Chili'sFundraiser - Chili's
Fundraiser - Chili's
Frisco Rfl
 
2011 silpada raffle ticket
2011 silpada raffle ticket2011 silpada raffle ticket
2011 silpada raffle ticket
Frisco Rfl
 
2011 Enjoy the City Flyer
2011 Enjoy the City Flyer2011 Enjoy the City Flyer
2011 Enjoy the City Flyer
Frisco Rfl
 
2011 Silpada Flyer
2011 Silpada Flyer2011 Silpada Flyer
2011 Silpada Flyer
Frisco Rfl
 
2011 Team Control Sheet
2011 Team Control Sheet2011 Team Control Sheet
2011 Team Control Sheet
Frisco Rfl
 
Youth Agreement & Chaperone Form
Youth Agreement & Chaperone FormYouth Agreement & Chaperone Form
Youth Agreement & Chaperone Form
Frisco Rfl
 
In Kind Donation Form
In Kind Donation FormIn Kind Donation Form
In Kind Donation Form
Frisco Rfl
 
2011 Relay For Life Kick-Off
2011 Relay For Life Kick-Off2011 Relay For Life Kick-Off
2011 Relay For Life Kick-Off
Frisco Rfl
 
Relay Pink In The Rink Flyer 2
Relay Pink In The Rink Flyer 2Relay Pink In The Rink Flyer 2
Relay Pink In The Rink Flyer 2
Frisco Rfl
 
FriscoRFL 2011 Sponsorship Snapshot
FriscoRFL 2011 Sponsorship SnapshotFriscoRFL 2011 Sponsorship Snapshot
FriscoRFL 2011 Sponsorship Snapshot
Frisco Rfl
 
FriscoRFL 2011 Sponsorship Packet
FriscoRFL 2011 Sponsorship PacketFriscoRFL 2011 Sponsorship Packet
FriscoRFL 2011 Sponsorship Packet
Frisco Rfl
 
FriscoRFL 2011 Frisco Cancer Fact Sign Sheet
FriscoRFL 2011 Frisco Cancer Fact Sign SheetFriscoRFL 2011 Frisco Cancer Fact Sign Sheet
FriscoRFL 2011 Frisco Cancer Fact Sign Sheet
Frisco Rfl
 

More from Frisco Rfl (12)

Fundraiser - Chili's
Fundraiser - Chili'sFundraiser - Chili's
Fundraiser - Chili's
 
2011 silpada raffle ticket
2011 silpada raffle ticket2011 silpada raffle ticket
2011 silpada raffle ticket
 
2011 Enjoy the City Flyer
2011 Enjoy the City Flyer2011 Enjoy the City Flyer
2011 Enjoy the City Flyer
 
2011 Silpada Flyer
2011 Silpada Flyer2011 Silpada Flyer
2011 Silpada Flyer
 
2011 Team Control Sheet
2011 Team Control Sheet2011 Team Control Sheet
2011 Team Control Sheet
 
Youth Agreement & Chaperone Form
Youth Agreement & Chaperone FormYouth Agreement & Chaperone Form
Youth Agreement & Chaperone Form
 
In Kind Donation Form
In Kind Donation FormIn Kind Donation Form
In Kind Donation Form
 
2011 Relay For Life Kick-Off
2011 Relay For Life Kick-Off2011 Relay For Life Kick-Off
2011 Relay For Life Kick-Off
 
Relay Pink In The Rink Flyer 2
Relay Pink In The Rink Flyer 2Relay Pink In The Rink Flyer 2
Relay Pink In The Rink Flyer 2
 
FriscoRFL 2011 Sponsorship Snapshot
FriscoRFL 2011 Sponsorship SnapshotFriscoRFL 2011 Sponsorship Snapshot
FriscoRFL 2011 Sponsorship Snapshot
 
FriscoRFL 2011 Sponsorship Packet
FriscoRFL 2011 Sponsorship PacketFriscoRFL 2011 Sponsorship Packet
FriscoRFL 2011 Sponsorship Packet
 
FriscoRFL 2011 Frisco Cancer Fact Sign Sheet
FriscoRFL 2011 Frisco Cancer Fact Sign SheetFriscoRFL 2011 Frisco Cancer Fact Sign Sheet
FriscoRFL 2011 Frisco Cancer Fact Sign Sheet
 

Virtual Survivor Form

  • 1. American Cancer Society Relay For Life Virtual Survivor Registration Form What is a Virtual Survivor? A Virtual Survivor is a person that has been diagnosed with cancer but cannot physically attend a Relay due to distance, time, illness, etc. These are the people in our lives that we CELEBRATE at Relay For Life, whether they can be with us at the event or not. How Does It Work? If you have a loved one who is unable to join us at Relay For Life, you can still pay tribute to them by creating a poster, photo, collage or t-shirt to honor them in the Caregivers’ Lap. You will be asked to join the lap with other Caregivers, carrying or displaying your tribute to your Survivor who could not be at the Relay. How do I sign-up? Register your Virtual Survivor by completing the form below and turning it in to your Relay’s Survivorship Chair or log on to your Relay’s website to register online. Why should I do this? Relay For Life is all about Celebrating Survivorship. We are all Relaying for someone special, through the Virtual Survivor program you can CELEBRATE the life of your loved one– even though they can’t be with you at the Relay. Plus, you will make them happy to know you are walking in their honor. Questions? Contact your Survivorship Chair for details! Relayer’s Name who will walk in their Survivor’s Honor: ________________________ Email: _________________________ Relay Team Name: _________________________________________ Virtual Survivor’s Name:______________________ Phone #: ___________________ Address: _____________________________________________________________ Email: _______________________________________________________________ Cancer Type/Date of Diagnosis (optional):___________________________________ Survivor’s T-Shirt Size: S M L XL XXL Please return to Kellee Albrecht at albrechk@friscoisd.org or fax to 972.687.7882.