Donation Form

The “Ride for Mom” event promotes awareness, information and education about lifestyle choices we can make right now to prevent diseases such as cancer, diabetes and heart disease. Funds raised are distributed locally to organizations that promote positive lifestyle choices.

Cancer, diabetes and heart disease are scourges of our generation. It is estimated that as a result of these three diseases alone, $800 billion to $1 trillion is lost annually in medical costs and lost employee time. The financial losses do not include the profound emotional and social costs to families and friends. Several major cancers, diabetes and heart disease are preventable through exercise and good eating habits, choices that all of us can make right now. Imagine the savings that would be realized if we as a society made better lifestyle choices.

Your donation, in any amount, will be deeply appreciated, and carefully used.

First Name *

Last Name *

Email *

Phone *

Address *

City *

State *

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Donation Amount: $

Card Number *

CVC *

Expiration Date *