Walk for Epilepsy Team LGS Foundation

TEAM LGS Foundation 2011

WALK ASSISTANCE

Financial Assistance is offered in the form of a one night complimentary stay at L'Enfant Plaza (Team LGS Foundation
Headquarters), courtesy of the LGS Foundation. You MUST be registered for Team LGS Foundation (through the LGS
Foundation) prior to submitting application. Click here to register.

Please fill out all of the required areas below to apply for a room. A representative will get back to you within a few weeks with a
determination.

First & Last Name:

Have you received
assistance before from the
LGSF?

Email Address:

Why is attending the walk
important to you?

Full Mailing Address:

Number Attending
Walk:

Please check the box to the right to
confirm you have already registered
for Team LGS Foundation

* Assistance is not guaranteed and is available on a first come, first serve basis.