Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Entry Type * Individual Team T-Shirt Size * Small Medium Large XL Relationship to the Look. Foundation * Individual impacted by PANS/PANDAS Family of someone impacted by PANS/PANDAS Friend of someone impacted by PANS/PANDAS Other Fundraising Commitment: I agree to fundraise at least $500 as an individual or $1250 for a team of 3 (1 swim, 1 bike, 1 run) for the Look. Foundation. * I agree Please let us know why you would like to join Team Look. If you are part of a team, please provide the team name and members of team Please, provide your Instagram handle we are asking for this in order to tag you in posts related to Team Look. Thank you! Donate Online
