Walkathon Registration Form

Registration starts at 09.00 AM
Sunday, September 08, 2019 - 10.00 AM

Venue: ERINDALE PARK, Mississauga ,
Areas C & D
( Mississauga Road & Dundas Street W)

Entry Fee : Ages 13 and above : $20
Below 13 : $10; Toddlers : Free

Special Offer : For those who participate in both events, we will have free food coupons for you at the walkathon

(Handi-Care Intl. will issue receipts)

Name :
Address :
City,Province :
Postal code :
Phone :
Email Address :
Donation Options :
Purchase Raffle Tickets Online : (Raffle Prizes List)
Select ticket
(The draw will take place on Sept. 8th at the Walkathon and you will be notified)
: $20-1tkt
Walkathon - Registrant / Pledger
: ( "Yes"- Registrant / "No"- Pledger)
 
No. of Registrant : No. of Adults:     No. of children:
If Pledging - Who are you Pledging for ? :
Total Amount (Raffle, Registrant, Pledge) : $
Comment :
Can your name be published on our website? :
Registration List
NAME Sponsor Registrant Walkathon Amount No. of Adults No. of Children
      
   Total 0 0 0