Registration for the Autism CARE Walk is $25 per walker and includes one tshirt.
*I am registering for the: 1 Mile Walk 2 Mile Walk Virtual Walk
*I am registering as: Individual Walker Team  
Team Name (if registering as a team):

I am:
*T-Shirt Size:
*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
Home Phone:
Cell Phone:
*Email:
 

*Required

If you are registering for a team or family, please list up to 6 names and T-Shirt sizes below. Team members 8 years old and under do not need to pay a registration fee; T-Shirts can be purchased for $10 each.

Please modify the "quantity" on the payment screen to reflect the number of participants you are paying for.

Name
T-Shirt Size
Name
T-Shirt Size
1
6
2
7
3
8
4
9
5
10

How did you hear about the Autism CARE Walk?:

 If "Other" please describe:
Comments: