take the pledge

I promise to go gold and light up my home/building and be an advocate for children with cancer in Virginia.

Do you represent a home or business?

Home

Business

Both

Business Name

First Name

Last Name

Phone Number

Please provide a home or business address so we can send you additional information you can share to spread the word.

Street Address

Street Address Line 2

City

Zip Code

State

Please tell us your story or who you're lighting up for.

Attach a photo here if you'd like! When we can match a face to your story, it makes it that much more meaningful.

Upload File

I give my permission for glowgoldva to share my story.

Yes, please keep me informed by subscribing me to updates and statewide advocacy efforts.*

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