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Events

Registering as an Independent (not part of a team)
Please fill out the following. (An * indicates a required field.)

Name on Your Web Page*

Your own web address will be
https://ssl.charityweb.net/cachelps/championswalk/ENTERED_TEXT.htm

Fund Raising Goal*

Your Name and Contact Info:

You will be able to log in to personalize your own web page and view donations.

$25 Adult (free t-shirt)
$10 Age 11-18 (free t-shirt)
Free 10 and under

T-Shirt Size *

By clicking this box I acknowledge that I have read and understand the Waiver for the 7th Annual Champions for Children 5K Walk.
Click here to download a copy of the waiver.

First Name*

Last Name*

Address*

Address, line 2

City*

State/Province*

Zip/Postal Code*

Country*

Preferred Phone

E-mail Address (and username)*

Please add me to your e-mail distribution list.

Password*

E-mail address will be your username

Confirm Password*

MasterCard Visa Discover

Credit Card Number*

CSC More info *

Expiration*

Name (as it appears on card)*