Welcome to Adult Guardianship Services

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REGISTER ON-LINE
To register on-line, complete this form and submit. Then proceed to the paypal page to submit payment.

REGISTRATION FORM
Deadline for registration July 16th

TEAM REGISTRATION

Captain*:
Address:
City:	State:	Zip:
Contact Phone:
Email Address:

TEAM MEMBERS - Name of Team**

Name:
Address:
City:	State:	Zip:
Contact Phone:
Email Address:

Name:
Address:
City:	State:	Zip:
Contact Phone:
Email Address:

Name:
Address:
City:	State:	Zip:
Contact Phone:
Email Address:

*The "Team Captain" is the main contact person.
**You may choose your team name, or Adult Guardianship Services will assign one to your team.

INDIVIDUAL REGISTRATION

Name:
Address:
City:	State:	Zip:
Contact Phone:
Email Address:

REGISTER BY MAIL
Print and Mail completed registration form with check or credit card information to:
Adult Guardianship Services, Mary Ann Thomas
2800 Euclid Ave., Suite 200, Cleveland, OH 44115
Checks made payable to Adult Guardianship Services
Call 216.696.1132 x143 with any questions.

REGISTER ON-LINE
To register on-line, complete this form and submit. Then proceed to the paypal page to submit payment.