2019 Adena Walk-a-thon

Team Name*

The team web address will be:
https://ssl.charityweb.net/lakotaonline/walkathon/TeamName.htm

Team Fundraising Goal*

As captain, you will be able to log in to personalize your Team Web page, your own web page, and view donations and members.

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*

Confirm Password*

*By clicking this box I acknowledge that I have read and understand the Waiver for this event.

ADENA PTO WALK-A-THON