EmailMe Form - Lincoln MS Walk Registration

Lincoln MS Walk Registration
We look forward to seeing you on May 1st!

Select any of the following options that apply:

Join the Committee

Volunteer the day of the Walk

Make a Donation

If you wish to make a donation, we will contact you for that donation. Thanks!

Name *

Address *

City *

State *

Zip Code *

Phone Number *

###

####

Email *

(We don't like spam email either! We will only use your email for important updates regarding the MS Walk. Thanks!)

Re-type Email *

Are you walking on a team?

Yes

What is the name of your team?

Who is the Team Captain?

All participants who raise $100 or more receive a T-shirt on the day of the walk.
What size would you prefer?

Small

Medium

Large

X-Large

XX-Large

Select one of the following. How do you relate to MS?

I have MS

I have a relative with MS

I have a friend with MS

Does not apply

How many years have you participated in the MS Walk?

What is the total number of people you will have in your group?

How many children in your group?

How did you hear about the Lincoln MS Walk?

Newspaper

"Save the date" postcard mailing

Radio

Poster/Brochure

Friend/Family member

Comments

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