Angela Hospice Home Care, Inc. · Walk of Remembrance Registration

Adult Registrations	Quantity
$40

Child Registrations	Quantity
$15 - (Ages 6-12)

(Ages 5 and under are free. They do not need to register and will not receive a T-shirt.)

Additional Donation (Optional)

$

Are you forming a walk team and raising additional funds for Angela Hospice?

Yes

No

Creating a fundraising team is a wonderful way to honor your loved one, while supporting a great cause!

TEAMS RAISING $150-$299 RECEIVE:
• Team poster with a photo of your loved one along the route

TEAMS RAISING $300-$499 RECEIVE:
• Team poster with a photo of your loved one along the route
• Team name in event program and on T-shirts

TEAMS RAISING $500+ RECEIVE:
• Team poster with a photo of your loved one along the route
• Team name in event program and on T-shirts
• Team name on banner

*Be sure to submit our Team Signup Form as well to tell us more about the special person you're remembering. The form link will be included in your confirmation email.

Team Name

*

Your Name

*

First Name

Last Name

Are you registering on behalf of a company/organization?

Yes

No

Company Name

Email

*

Verify Email

*

Billing Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Guest Information

Adult #1

*

First Name

Last Name

Adult #1 T-shirt Size

*

Adult #2

*

First Name

Last Name

Adult #2 T-shirt Size

*

Adult #3

*

First Name

Last Name

Adult #3 T-shirt Size

*

Adult #4

*

First Name

Last Name

Adult #4 T-shirt Size

*

Adult #5

*

First Name

Last Name

Adult #5 T-shirt Size

*

Child #1

*

First Name

Last Name

Child #1 T-shirt Size

*

Child #2

*

First Name

Last Name

Child #2 T-shirt Size

*

Child #3

*

First Name

Last Name

Child #3 T-shirt Size

*

Child #4

*

First Name

Last Name

Child #4 T-shirt Size

*

Child #5

*

First Name

Last Name

Child #5 T-shirt Size

*

Notes