Benefiting the American Cancer Society Relay For Life

Tuesday, August 6th, 2013 6-8PM

Bergen Town Center Paramus, NJ Return this form postmarked no later than July 29th by mail: American Cancer Society, Baking For a Cure, Attn: Jessica Gaeta, 20 Mercer Street, Hackensack, NJ 07601. Participants will all receive a Certificate of Appreciation and a Relay For Life gift. Cakes must make at least 100 small, two or three bite pieces. YES, I would like to enter the Baking For a Cure Cake Decorating and Tasting Contest. If you would like to make a monetary donation as well please include a check or cash with your registration form (Checks made out to American Cancer Society). Skill (Please Circle One): Professional or Amateur Name of establishment and/or participant:_______________________________ Mailing Address:__________________________________________________ City:_____________________________________State__________Zip______ Phone:___________________________Email:__________________________ Name of entry:____________________________________________________ Baking in Honor/Support of: ________________________________________ Please read and sign below: I agree to provide one cake to be judged on August 28th, 2012 at Bergen Town Center in Paramus, NJ. I will use wholesome, fresh ingredients and no raw eggs/egg whites will be served. I will provide transportation of the cake to Bergen Town Center (Route 4 East and Forest Avenue, Paramus, NJ). I give permission for my photo to be taken and my name and image used in all media efforts following the event. Should you have an issue with any of these requirements please email jessica.gaeta@cancer.org or call 201.457.3418 x 2227. Name (Printed)______________________________ Signature (If Under 18, parent/guardian must sign):___________________________ Date _______________ Once this application is received, your participation will be confirmed by email or phone. THANK YOU!