Register

Registration for the CARE Walk is free, but participants must raise a minimum of $25 to be eligible for an event T-shirt and walker bag (T-shirt and tote bag prizes are not cumulative and cannot be transferred to another walker). Register by March 28, 2010 to be guaranteed your T-shirt size.

The online registration process allows you to review and electronically sign the participant waiver, and complete registration online.

Once you are registered, you will have access to tools to accept pledges online and share your personal CARE Walk fundraising page with your family and friends. You can register as an individual walker, a team, or a virtual walker.

* I am registering for the:

2 Mile Walk
Virtual Walk

I would like to:

I am:

Contact Information

* First Name:
* Last Name:
* Address:
* City:
* State:
*Zip:
Home Phone:
Cell Phone:
* Email:
Sign me up for email updates about the CARE Program and Heartspring.

Team Members

Parents: Please list names and ages of all children walking but not able to complete a registration form themselves.

If you have young children that will be participating, please enter their names and ages below. Adults and children old enough to register themselves should complete their own registration form. They can still join your team by either selecting the team name above or by visiting your profile and clicking the "Join My Team" button on your My Team tab.

	First Name	Last Name	Age
1
2
3
4
5

My Fundraising Page

Fundraising Goal: $
My Fundraising Goal
Specify the amount you are hoping to raise for the Autism CARE Walk here. The amount you enter will be displayed on a special fundraising thermometer on your profile.
* Username:
* Password:
* Confirm Password:
How did you hear about us?
Please describe:
Questions/comments:
Please read the following waiver you will be asked to sign the day of the walk:

RELEASE: In consideration of my participation in The Autism CARE Walk at Heartspring, the undersigned does hereby fully release and discharge Heartspring, their officers, employees, board of trustees, as well as any and all other sponsors of the The Autism CARE Walk of and from any and all damages or injuries, whether to my person or my property, whether such injuries are accidentally or negligently inflicted or suffered, arising out of or in connection with any and all events associated with the The Autism CARE Walk, including the rendering of any emergency care, hospitalization or treatment. The undersigned does hereby acknowledge that certain dangers are inherent in physical activities; and that the undersigned does hereby expressly accept and agree to assume all such risks. I give Heartspring permission to use video recordings and/or photographs that I may appear in during this event, for the production of promotional materials, publications, and/or releases to the news media. Those under 18 years old must have a parent or guardian signature. An adult must accompany children 15 years or younger.

I have read and agree to this waiver. *
Verify the characters:
To help us cut down on spam, please enter the 5 black characters you see displayed in the image. This is case-sensitive.

My CARE Walk