Registration

Instructions: Please complete and submit the following form to register for the UPWSA Fitness Fun-Raiser event.

= Required Field
Type of Registration
Type of Registration
$10 per individual OR
$30 for 4 immediate family members ($5 for each additional immediate family member)
Number of Participants The number of individuals you are registering—including yourself

Contact Information
First Name
Privacy Policy
The Utah Prader-Willi Syndrome Association uses your contact information to process your donation and ease the registration process for this event. We may use this information to send out thank-you cards and information on upcoming events.

We will not disclose your personal information to any third party for other private or business uses. We may disclose your personal information when required by law or litigation.
Last Name
Address
City
State
Zip
Phone
Email (used to email donation receipt)

T-Shirt Sizes
Qty. Size Each registered participant will receive an event t-shirt.

Based on the number of individuals you are registering, enter the number of t-shirts you need for each shirt size.
Adult: Small
Adult: Medium
Adult: Large
Adult: Extra Large
Adult: 2 XL
Child: Small
Child: Medium
Child: Large

In Honor Of
First Name
Last Name
Enter the name of the individual for whom you are donating in honor of (if any).

Write A Message
Message(maximum 85 characters)
For all participants and/or donors, we would be happy to print a short, personalized message that will be displayed at the event.

Example:
"Nathan, Thanks for sharing your smile with us. Love, The Jones Family."

Donations
Registration Donation: $ Enter an additional amount if you'd like to donate more than the registration amount.
Your donations are tax-deductible and will be used to help fund medical research, to sponsor Utah PWS conferences, and to provide respite care and educational materials for Utah families.
This year we also hope to help our youth attend Camp Kostopulos (a special needs summer camp located in Utah), and help send individuals with PWS to the Tanner Dance summer camps/classes at the U of U for people with dissabilities.
Additional Donation: $