Walking with Purpose Registration Form Name* First Last Email address* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Home Phone*Cell Phone**Ok to send text messages?*YesNoI will need childcare (Offered for children preschool age & under)* Yes No # of children (please list child's name & age) Emergency Contact* First Name Last Name Emergency Contact Phone*Registration Fee* Price: $30.00 The link for payment will be provided in your confirmation email once registration is submitted.
