Register Here | Walk for Life

Walker Information

Age *

Guardian First NamePlease provide the first and last name of a parent or guardian in order to approve your participation. *

Guardian Last Name *

Guardian EmailPlease provide the email address of a parent or guardian. We will send an email so the guardian can approve this account. *

SalutationWill be displayed before your name on the fundraiser page.

First name *

Last name *

Email *

City *

State *

Address *

Address 2

Zip Code *

Mobile Phone *

Family Guardian ConsentI affirm that the email I've provided is owned by an adult, and that this registration is made with the adult's consent.

How did you hear about us? *

Why are you raising funds for Walk for LIFE?

Fundraiser Details

Customize the text on your fundraising page - tell a story, explain why you are raising funds for LIFE... *

Fundraising goal ($) *

Upload a profile image for your fundraiser. For best results, the image should be square and at least 300px wide. *

Replace

Choose an EventSelect the Walk event in which you would like to participate. *

Chesapeake City Park
Virginia Beach Town Center
Virginia Zoological Park
Virtual

Have you raised funds for Walk for LIFE in the past? *

Consent to receive notifications and participate in the Walk for LIFE.RELEASE AND WAIVER: For and in consideration of my participation in Our event, I hereby, for myself, my heirs, administrators, and assigns, release and discharge the venue and all involved sponsors and their respective servants, agents, employees, officials and officers, from any and all claims, demands, liabilities, loss, damage and causes of action of any sort, including attorney’s fees for injuries sustained to my person or property incurred by reason of my participation or preparation for the above said event due to negligence or any fault. I hereby grant the organization specific permission to reproduce, publish, circulate, copyright, or otherwise use any and all photographs and/or videotape of me and/or my family taken at Our event, for use by the organization. I certify that my participation is free and voluntary. By clicking on the “Complete Registration” button below, I signify that I have read and understood the foregoing Release and Waiver, and, if under the age of 18, have the consent of a parent or guardian to participate in this event. *

Guardian Consent ProvidedBy checking this box, I confirm that I have received consent from my guardian to participate in the Walk for LIFE event.

Enter your information