Duck Adoption Sign Up
Form
Mini rubber ducks will be dropped in the pool
at Laurel
Ridge Country Club around 6 PM on Saturday, July 23, 2026.
The ducks that reach the end of the pool first will win the
prizes listed below.
PRIZES:
1st Place –
$1,000 (increases to $2,000 if at least 2,000 rubber ducks are
adopted)
2nd Place –
Two-night stay in a Royal Palm Studio Aparto at Bridgewalk
Resort on Anna Maria Island, FL
3rd Place –
A full-day guided fly fishing wade trip for two with Maggie
Valley Fly Shop, valued at $500.
4th Place–
$200 Walmart gift card
All ducks are numbered and assigned to the individuals
who adopted them, helping us determine the winners.
You do not have to be present at this
event to win prizes. We will
contact you via email if you win anything. *Check
out our duck race from last year.
This form is only for those paying for duck
adoptions by credit card. The cost of adopting ducks for the
race is slightly higher when paying by credit card due to processing
fees. If you wish to pay by check, please download this Duck
Adoption form and mail it to Medical Patient
Modesty, P.O. Box 652, Hazelwood, NC 28738 along with
a check payable to Medical Patient Modesty.
*After completing this form,
you will be redirected to a webpage where you’ll need
to click the “Continue to Pay”
button. Make sure to complete that step to finalize your payment
by credit card.
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