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Register to be an Organ Donor

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Please answer all questions.

First Name

Last Name

Email

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Select One

Transplant Recipient

Living Donor

Donor Family

Supporter

Tell us your story

If you are a transplant recipient, what type of transplant did you have?

Where did you have your transplant?

When did you have your transplant?

If you are a living donor, what did you donate and to whom?

If you are a donor family, tell us about your loved one.

If you are a supporter, what is your connection to Organ & Tissue Donation?

If employed, where do you work and what is your occupation?

Do you have any special talents that would benefit Team Mississippi (examples: graphic design, embroidery, event coordinator, 5k organizer, etc.)

Sports you are interested in

Basketball

Volleyball

Bowling

Lyrics for Life

Pickleball

Badminton

Trivia Challenge

Table Tennis

Texas Hold'em

Track and Field

Ballroom Dancing

Darts

Cycling

Swimming

Cornhole

Tennis

Virtual Triathlon

Youth Olympiad

Donor Family Trivia

Golf

5K

Upload photo

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Are you ok with us sharing your information in our team directory?

Yes

No

If yes, is there anything that you don't want shared?

Previous Games Attended

2024 Birmingham

2022 San Diego

2018 Salt Lake City

2016 Cleveland

2014 Houston

2012 Grand Rapids

2010 Madison

2008 Pittsburg

2006 Louisville

2004 Minneapolis

2002 Orlando

2000 Orlando

Thanks for submitting!

Thank you to our 2023-2024 Partners

CONVILLE & CONVILLE, PLLC

Amy & Doug Robertson

Mississippi Kidney Foundation Rosemarie Cascio Newts Catfish Jackson Family Dentistry

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