Relay for Life Koozie Order Form

    Koozies are provided free to your chapter as a way to fundraise at Relay for Life.
    *The amount of koozies you receive will depend on the number of chapters that request them.

    *Select Chapter: [chapterselect]

    Date of Event (required)

    Your Name (required)

    Are you the Relay for Life Officer for your chapter? (required)

    Your Email (required)

    Your Phone (required)

    Please provide an address for us to send koozies to: (NO P.O. Boxes)

    Address Line 1 (required)

    Address Line 2

    City (required)

    State (required)


    Zip Code (required)