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Be an Encourage Sponsor

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OR

Payment options appear after this form.   

Please press the "Submit" button on the form above before making payment.  

Mail a check payable to the ELW Drive for a Cure and copy of this form to:

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Charlene Mixa

5048 Pinnacle Drive

Oldsmar, FL  34677

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For additional information, call:

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727.753.3111

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Submit the form above and pay below:

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Thank you
for your registration.  We will confirm by email.

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 by the ELW Drive for a Cure.  All rights reserved.  2019

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The ELW Drive for a Cure is a not-for-profit organization under the IRS Code 501(c)(3), whose Tax ID is 82-3828428.   All net proceeds from this event go to our designated beneficiaries.

 

FLORIDA REGISTRATION NUMBER CH60670:  ACOPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE.  REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

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