Ethan's Voice

Date: Sunday, September 15, 2024
Location: Meadowland Park, 160 Main St. S, Brampton
Time: 12:00 noon

This event is a 3k walk to raise money for Autism Ontario Central West Region, Children, Youth & Family Programs.

You are completing this form on behalf of someone else. Please enter their details.

Amount *

$100.00

$50.00

$25.00

Other

Total Amount

Please do not enter the "&" symbol in the name field as the transaction will not go through.

Additional Information

I prefer to make this donation anonymously *

Yes

Note to Charity:

Donor Name and Address

First Name *

Middle Name

Last Name *

Email Address *

Street Address *

Phone *

City *

Province *

Country *

Postal Code *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Phone *