Our Walk For Life
Online Registration

Required fields are in RED

      Please Select Charity:
       Kimberly Home
       Bay Area Pregnancy Center

Child:
Child:
Child:
Child:
Child:
Child:
Child:
Child:
Child:
Child:
Upload Team Picture  

Note: Only .jpg, .jpeg, .png formats allowed to a max size of 5 MB.
Ensure only Portrait Pictures for correct display



Registration Fees
Option Price     Qty
Adult $5
Child 12 and under $5
Donation (OPTIONAL, but appreciated) $
PayPal Fee (OPTIONAL, but appreciated) $0

Total $0  

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Payment

Please complete the Form completely as we will have to make any edits for you once you submit.

Note, PAY NOW is immediate payment and takes you to the Paypal site.
You can pay with credit card or Paypal, You do not need a Paypal account
If you want to pay by check, then at the Paypal site, simply close the browser window, and send a check.
Any questions, please contact us using the contact form