Walk for Cancer Registration Form

Walk for Cancer Registration Form
Location: N. Charleston Sports Complex - 1455 Monitor St., N. Charleston, SC 29405
Race Dates: May 31, 2025
Time: 9:00AM - 10:30AM
Participant Details
Full Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Person*

First NameLast Name
Emergency Person Phone Number*

Area CodePhone Number
Relationship to Emergency Contact Person*
T-shirt Size*

XSSMLXLXXL3XL4XL
Registration Payments
Payment Method*
Registration Fee
prevnext( X )
Walk/Run$20.00

Total $0.00
Credit/Debit Payment Link:

Click HERE for payment.
Waiver & Release
I confirm that I am in good shape, health, and condition.I don't have any medical condition or medical history that will affect my participation in this event.I will follow the rule and regulations of the road race event.I acknowledge that this walk requires physical activity and there are possible risks and danger.I release the walk event organizers for any responsibility in case of an accident, illness, or injury.I allow my photo to be taken during the event and used for event advertising and marketing.I confirm that all information in this registration form is accurate and true.
Participant's Signature*

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Date Signed

MonthDayYear
Date
Parent/Guardian Signature (If participant is below 18 years old)

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Should be Empty:

Walk for Cancer Registration Form

Participant Details

Registration Payments

Waiver & Release