Walk to Remember Registration Form

Walk to Remember Registration Form

www.magriefcenter.org
We look forward to seeing you on Saturday, October 10 at 10:00am.

Filling out this form is completely optional. Completing this form helps us contact you in the event of any changes (weather, etc.) made to our walk. Even if you complete this form, you are not obligated to attend the event. You can also attend this event even if you do not complete this form.

Please note that we are saddened to share that the Massachusetts Center for Unexpected Infant & Child Death is closing effective October 15, 2026. Our 2026 Walk to Remember is still being held. Our commitment to families and professionals will continue via the National Center for Unexpected Infant & Child Death. Please visit us at www.ncuicd.org.
Name

First NameLast Name
Email
example@example.com
Secondary Name

First NameLast Name
Secondary Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Estimated number of attendees in your group
Who are you remembering? Please include as many names as you'd like.
Would you be interested in speaking at a future Walk?
Should be Empty: