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Walk of Hope
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Team Name
Select option...
No Team - Walking as an Individual
The Cancer Stompers
Clownin' Around for a Cure
Family LifeCare
Heart to Heart
Heart & Sole
Hoosier Jiffy Print
MGH-Donna Knight
#SmilingStrong
#TeamMathias&Carter
Other
If your team is not listed, scroll to the bottom of the list and select "other" and type your team name.
TEAM INFO
If this is a new team, are you registering as Team Captain?
Yes
No
WALKER INFO
*
Name - Walker #1
*
#1 - Adult, Youth, or Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#1 - Purchase Cancer Services Event T-Shirt?
Select option...
Small - $15
Medium - $15
Large - $15
X-Large - $15
XX-Large - $18
XXX-Large - $18
XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #2
#2 - Adult, Youth, or Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#2 - Purchase Cancer Services Event T-Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #3
#3 - Adult, Youth, or Angel
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#3 - Purchase Cancer Services Event T-Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #4
#4 - Adult, Youth, or Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#4 - Purchase Cancer Services Event T-Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #5
#5 - Adult, Youth, Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#5 - Purchase Cancer Services Event T-Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #6
#6 - Adult, Youth, Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#6 - Purchase Cancer Services Event T-Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #7
#7 - Adult, Youth, Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#7 - Purchase Cancer Services Event Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
Name - Walker #8
#8 - Adult, Youth, Angel?
Select option...
Walker: Adult - ages 18 and over ($5)
Walker: Youth - ages 5 - 17 ($5)
Virtual Walker: Adult - ages 18 and over ($5)
Virtual Walker: Youth - Ages 5 - 17 ($5)
Angel ($5)
#8 - Purchase Cancer Services Event T-Shirt?
Select option...
Adult Small - $15
Adult Medium - $15
Adult Large - $15
Adult X-Large - $15
Adult XX-Large - $18
Adult XXX-Large - $18
Adult XXXX-Large - $18
Youth Small - $15
Youth Medium - $15
Youth Large - $15
SURVIVOR INFO
Please check all walkers from above (excluding angels) who have ever been diagnosed with cancer.
#1
#2
#3
#4
#5
#6
#7
#8
CONTACT INFO
*
Name
*
Address
*
City
*
State
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Delaware
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Hawaii
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Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
*
Email
SHIPPING INFO
Would you like your shirts shipped to you?
Select option...
Pick Up - FREE
Ship 1 Shirt - $5
Ship 2 Shirts - $7
Ship 3-4 Shirts - $9
Ship 5-6 Shirts - $10
Ship 7-8 Shirts - $12
ADDITIONAL DONATION INFO
Help cover credit card costs by donating $1 or make an additional donation to help people facing cancer in Grant County?
Select option...
1
Other
WAIVER
*
Cancer Services of Grant County is not liable for any injuries or property damage sustained during the Walk of Hope. By selecting YES, you signify that all parties above (or their parent/guardian if under 18) have read, understand, and agree to waiver.
Select option...
YES
No - (You must choose YES to be able to participate in the Walk)
Would you like to create a fundraising campaign?
Yes
No
* Campaign name
* Goal
Payment Information
Total: