Walk For Life Registration Form
Walker's Nameyour full name
Addressyour full address
City, State, Zipyour city, state, zip
Phoneyour phone number
Adult T-Shirt SizeOne t-shirt per registered walker, while supply lasts. Pick up your shirt at The Center before Thursday, May 9th or at the Walk
Team Nameyour team name if applicable
$25 Registrationpick one!

I and/or my dependents participate in the Walk for Life and/or its activities at our own risk. We do not hold the The Center liable for any injuries or damages arising therefrom. We also give The Center permission to use photographs taken at the event for future promotional purposes.

You can complete the online form on the left or click below to print out the Walk for Life Registration Form and return it to The Center.

PLEASE NOTE: Payment MUST must be made online with your registration in order to reserve a t-shirt. T-shirts are available while supplies last.

To make a safe and secure donation by CREDIT CARD or Paypal, please follow these instructions. You DO NOT need a Paypal account in order to process a credit card payment. To make a payment, press the yellow DONATE button below, then enter the amount of your donation (eg. 25.00) then press CONTINUE to the next page to use your Credit Card for payment. Press the gray button below the Paypal login “PAY WITH DEBIT OR CREDIT CARD” to enter your card information and complete the transaction.

Donation Type
Walk for Life
Walker being Sponsored