Yes, I would like to join the Chesapeake-Potomac Spina Bifida
Enclosed is my $25 annual membership fee.
( ) I would like to join, but I am unable to make a donation due to financial hardship
I am a ( ) parent of a child with spina bifida ( ) an adult with spina bifida ( ) a relative ( ) other: _______________
Please make check payable to and mail to:
Chesapeake-Potomac Spina Bifida
Please check below if you would like to:
( ) Receive more information about CPSB
( ) Become a volunteer
( ) Make a non-monetary donation to CPSB
For further information, contact the association at 1-888-733-0988.
Spina Bifida, Inc.
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