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 first duck that goes to the end of the pool will win a grand
prize. The grand prize (1st place) will be $2,000
if we get a presenting sponsor. *Check
out our duck race from last year.
Other prizes are:
Check this web page as time gets closer to see an
updated list of prizes. We will have smaller prizes for 2nd,
3rd, 4th, and 5th place ducks.
All ducks are numbered and assigned to people
who have adopted them. This will help to 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.
This form is only for those who are paying for
adoption of ducks by credit card. The cost of adopting ducks
for the race is a little higher if you pay by credit card due
to the 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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