Registration Form

Name:________________________________

Address:_______________________________

City:________Province:_______Postal:______

Phone:________________________________

Email:________________________________

Registration fee $20.00 and $5.00 for students- Please note that we do not want anyone to feel like you can not walk if you can not afford the fee.

We are offering a sliding scale to registrants who want to walk. So don't be discouraged. Come out and walk and lend your voice!

Date:___________________________________

Print name:______________________________

Signature:_______________________________ (If under the age of 18, must be signed by guardian)