REGISTRATION/ENTRANCE FEE $10 MINIMUM PER PERSON

I am registering as a:

*

Individual Walker

Select the appropriate option below.

Are you a first time or returning participant?

I'm new to the Walk for the Way.
I'm a returing participant.

My fundraising goal is:*

Individual Commitment Sign-Up Form

Title*

Mr.Mrs.Ms.Mr./Mrs.

First Name*

Last name*

Company Name (if applicable)

Mailing Address*

City*

State*

Zip Code*

Phone #*

Email Address*

Comments

Tell us where you first heard about the walk:

Radio Print Ad Mail/Postcard Email TV Agency

Bank the Bulks

Imagine coming to the Walk with your tote or T-shirt already on and all you have to do is have fun and walk. Sounds good? Take advantage of our Early Bank Day, Wednesday, September 22. Please note that this is not the final deadline for money! Any additional funds can be turned in at the Walk and/or mailed to our Office. In addition to turning in your money , pick up your event materials (free tote and entrance bracelet).

Registered Walker(s)

Registered walkers must be 18 years old. Minors under 18 years of age must be accompanied by a parent, legal guardian or adult during the event.