Register for the Fourth Annual Walkathon

Adults - $19.20 (10 meals at Open Door Mission)
Children 12 and under: $9.60 (5 meals at Open Door Mission)

Please register to WALK A MILE IN MY SHOES below

E-mail: *

First Name: *

Last Name: *

Affiliated Organization:

(Church, Business or Group)

Phone Number: *

Type of Phone:

Address:

City, State Zip:

I am 18 or older: *

Name of Parent / Guardian:

Only applies if you are 17 or under

How Many will be in your group

Adults: *

Children 8 and under: *

Names of the people in your group:

Providing the names of everyone in your group will help registration move faster the day of the walk.

Registration Donation: *

Adults-$19.20 / Children-$9.60 Proceeds feed hungry and homeless men, women, and children at Open Door Mission

Additional Comments:

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Math question: * 4 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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