Please display my name on the participant's public donor wall as:
Please do not display my name on the donor wall.
Participant Information
Event Name2024 Northeast PA Heart Walk
Event ID10083
Participant ID28432782
Participant NameNorma Jean Weitz
Team NameWilkes-Barre General Hospital
Team ID
Mailing Information
Please send this completed form with checks to:American Heart Association | Attn: Northeast PA Heart Walk | 4250 Crums Mill Road | Harrisburg, PA 17112