North-Central Football Pink Out Ceremony (6pm Friday 10/11)

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PLEASE NOTE THESE DETAILS AS YOU WILL NOT RECEIVE AN E-MAIL BEFORE THE CEREMONY......Participants should meet by the south endzone (opposite side of the field from the concession stand) at 6pm for instructions. We will form a tunnel for the football team to come through, then move to the sideline for a brief ceremony recognizing those who stand united against breast cancer. E-mail northpublicservice@gmail.com or call/text 847-780-7378 with questions.

Please enter the participant's first and last name. *

(depending on the size of the group, we may read the names of the participants at the ceremony; enter the name as it should be read)

Please indicate the age range of the participant:

(this is to help us organize the participants for the ceremony)

0-3

4-8

9-13

14-18

19-26

27-39

40-64

65 or over

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Which best describes your reason for participating?

(check all that apply)

I am a survivor of breast cancer

I am a family member of a breast cancer survivor

I have lost a family member or friend to breast cancer

Other:

Please enter your e-mail address. *

YOU WILL NOT RECEIVE A CONFIRMATION E-MAIL; please note the instructions after you click Submit.

Are there any special needs or mobility difficulties we should be aware of?

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