RELAY FOR LIFE

Georgetown University

Luminaria Order Form

EASTER LUMINARIA CHALLENGE

Relay for Life of Georgetown University is all about celebrating life. On the night of the event, our Relay track will be lit with hundreds of Luminaria bags to honor those who have fought and to remember those we have lost. At dark, our Luminaria ceremony will further memorialize our loved ones’ struggle with cancer, will celebrate survivorship, and inspire hope for a cure!

-To purchase your Luminarias with CASH or CHECK, provide the information below. The suggested donation is $10 per bag. Return the form to your team captain. The GU Luminaria committee will dedicate your bag and place it around the track.

-If you would like to pay by CREDIT CARD, please go to RelayGU.org, find your team, find your participant, and enter the amount you wish to donate. You will be taken to a donation page to fill in all your information. At the top, select Luminaria Donation. The GU Luminaria committee will dedicate your bag and place it around the track.

Please check here if you would like to decorate your own Luminaria bag. The day of the event, you will be able to pick up the bag, design it, and return it to the Luminaria Tent.

Please Print

Your Name:

Address:

City: State: Zip:

Phone: Email:

In memory of: In honor of:

In memory of: In honor of:

In memory of: In honor of:

In memory of: In honor of:

In memory of: In honor of:

In memory of: In honor of:

Total Number of Luminaries: Amount enclosed:

Team Name: ____________________________ Participant:_________________