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Payment options appear after this form.

Please press the "Submit" button on the form above before making payment.  Registration is complete upon receipt of payment.

Submit the registration form above and make check payable to "ELW Drive for a Cure."  Mail check to:  

Marianne Rechtoris
3505 Tarpon Woods Blvd, F41
Palm Harbor, FL  34685

or

Submit the registration form above and pay below:

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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