Twin Cities Walk for Parkinson’s Disease

Registration
*Required		 The Walk is Saturday, May 1. The Walk begins at Wolfe Park, 3700 Monterey Drive in Saint Louis Park. Registration begins at 9:30 a.m. The Walk begins at 10 a.m.

First Name:*

Last Name:*

Street Address:*

City:*

State:*

ZIP Code:*

Phone:*

Email address:*
 * 

I agree to specifically waive, release, absolve, indemnify, covenant not to sue and agree to hold harmless Parkinson Association of Minnesota, city of St. Louis Park , committee members and Walk sponsors for any claim, loss, damage or injury arising from participation in the Twin Cities Walk for Parkinson's Disease, May 1, 2010 . I agree to have my photograph (still and video) and the photograph of my children (if applicable) used in publicity.

Names of children, under 18, walking with registrant:
  (One name on each line)

Check one: *
  I will bring my donations the day of the walk.
  I will donate via credit card at www.charitybox.com/pam.
  I will mail my donations to the PAM office before Walk Day.

Select any of the following, if applicable:

 

My company is matching my donation.

 

I am interested in joining the Parkinson Association of Minnesota.

 

I am interested in upcoming events.

 

I know of an organization that is interested in sponsoring events.

How did you hear about the Walk?
 
Other information or comments:
  (Optional)
 

Thank you for registering online.
On the morning of the Walk, please go to the Pre-Registration Table to receive your materials.