Walk With Angels


An 8 Mile Walk for the Cure!


This  is a Kimberley Chance Atkins Foundation Event.

2012
Walker Registration
You are registering as an Individual Walker. If you want to join a team, click here.
Walker Personal Information
Your Name:    
Address:  
City:
  State:   Zip Code:  
Home Phone:  
Cell Phone:  
Email Address:  
Birth Date:    Sex:
select
 
T-Shirt Size:
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  Cancer Survivor?:
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Medical Information
Describe Any Allergies:  
Emergency Contact Name:   Relationship:      
Contact Phone:   Alternate Phone:      
 
  I hereby release the above information to the Walk With Angels medical team and any other medical personnel, hospital personnel, etc., that may need to care for me during the walk. By submitting application, walker assumes all risks and dangers incidental to the walk and releases the Walk With Angels, its sponsors, participants, and all agents from any and all liabilities resulting from any and all activity associated with the walk.

About Your Walk
Be a Walking Coach?:
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  Share Contact Info?:
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Personal Page Title:  
Your Personal Message:  
Are You a Sponsor?
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 * Sponsor registration does not require entry fee.		  
My Goal $:   <<- Minimum goal for individual walker is $300  
Entry Fee:  (entry fee is applied to your donation minimum)  
Additional Donation:   (optional)  
   
  By submitting this registration, I acknowledge my personal commitment to raise a minimum of $300. For non-online donations, I understand I must submit a completed donation form with each individual donation to assure an accurate deposit to my fundraising account.
Once your registration is accepted, you will be directed to the Walker Donation Page to pay your registration.
  
  Registration Closed