Walk-a-thon / Register

Personal information

Individual Registration : $35 Family Registration : $70
For three or more family members Student : $15
Contribution
If you cannot attend and /or want to make an additional contribution, please enter the amount below:
$ Dollars . Cents
T-Shirts
One free t-shirt per registration; $10 for each additional shirt. Indicate number of additional t-shirts per size you would like to order (ie. the number "1" for one t-shirt):

Add'l Large ($10 each) Add'l X-Large ($10 each)
Waiver
I hereby waive all claims against St. Leonard’s Ministries, event sponsors, personnel and agencies for any injury I might suffer while participating in this event. I attest that I am physically fit and prepared for this event. I grant full permission for organizers to use photographs of me in legitimate accounts and promotion of this event. If I am a minor, I attest that my parent/guardian has read and understands this waiver.
Note
All participants are urged to collect a minimum of $100 in pledges; pledges can be turned
in the morning of the walk or mailed to: St. Leonard’s Ministries, 2100 W. Warren Blvd.,
Chicago, IL. Download the pledge form here (PDF).