First Name(required) Last Name(required) Email(required) Phone(required) Team Name Address(required) Please choose an option(required) I plan on walking the full 24 miles My team plans to walk as a relay for the full 24 miles I plan to walk a portion of the walk (please note number of miles) My team plans to walk a portion of the walk (please note number of miles) Number of miles Date of Birth (MM/DD/YYYY)(required) Emergency contact number(required) List additional team members here. Send
