Cancer Survivors Registration

Cancer Survivor Information

Please DO NOT submit this registration unless you are already booked on the 2024 Buckeye Cruise.

First Name*

Please enter a valid first name.

Last Name*

Please enter a valid last name.

Email Address*

Please enter a valid email address.

T-Shirt Size (unisex sizing)*

Please select a valid t-shirt size.

Cancer Type or Color of Cancer Ribbon*

Please enter a valid answer.

Buckeye Cruises Attended*

Please select a valid t-shirt size.

Would you like to participate in opening night ceremonies?*

Yes No

Please select a valid answer.

Would you like to participate in the Survivor/Athlete Breakfast on the ship?*

Yes No

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Do you authorize the Buckeye Cruise/OSUCCC - James to use your name, photo, and/or story when promoting the Buckeye Cruise for Cancer?*

Yes No

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Tell us why you support the Buckeye Cruise for Cancer (limit 250 characters)

Photo Submission
(Optional)

I voluntarily give my permission to The Ohio State University and Buckeye Cruise for Cancer for my image and/or voice to be recorded, published and/or distributed for news, educational, marketing or publicity purposes. I understand that once this protected information is printed, recorded and/or electronically posted, Ohio State nor the Buckeye Cruise for Cancer retains no further control over its use.*

Agree Do Not Agree

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