FREEDOM WALK REGISTRATION FORM

Personal Details

Name *

First

Last

Email *

Phone

Birthdate

Shirt SizeSmallMediumLargeXL2XL3XL4XL

Run or Walk

• Runner
• Walker

Participation means any photos of you may be used in future marketing. *

• I understand.

Emergency Contact

Birthdate Goal: Emergency

Name *

First

Last

Phone *

Goal: Total Amt to Raise *

Please add dollar amount you plan to raise

Submit

Please note: Registration fee MUST be paid by November 1, 2024.