Individual Team Member

Please fill out or print the form below and send in your registration dontation

Register as an individual member of a team. Remember to invite 3 other players to make up your team.  The individual team member donation is $125.

Please tell us about yourself, Register By Mail or Register Online.  You may submit your donation via check, in person or right here via credit card.  See Payment Options for instructions.

Register By Mail

Or Register Online

Please tell us about yourself

Select your donation options
Donate OnlineBy MailIn Person
if donating online, remember to click the donate button on the right when you have submitted this form

Remember to send in your donation.

Remember to invite 3 other teammates to join you.

Payment Options

Donate online

Just click the button and pay with a credit card or your paypal account.

Team Member Donation: $125

Donate by Mail

Make Checks Payable to “The Free Medical Clinic” and mail to:

The Free Medical Clinic
6209 Chapman hwy.
Knoxville TN 37920
** remember to include your printed registration form

Donate in person

Just stop by the clinic anytime.