W2R Walk Registration

Walk 2 Remember Registration Form

Individual/Team/Corporate/Virtual
Thank you for partricipating in the 2026 Walk 2 Remember & Car Show. The beneficiaries of this annual event are the families and caregivers who struggle daily with memory loss. Your sponsorship of this event will provide exposure to you and your organization, and also help Our PLACE to continue providing "Moments of Joy" to so many individuals.

October 10th – Lenoir City Park – 9 A.M. to 1 P.M.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
E-mail
Are you walking as an individual or part of a team or corporate team?
Team Name
Corporation Name
You must select the date window that corresponds with when you are actually filling out and submitting this form.
Categories:All

All

Additional Donation
prevnext( X )
Walk Registration & T-Shirt (select size below in form)
$30.00



Register before August 15 - $30
Free Quantity



Register between August 16 - October 1 - $35
$35.00 Quantity



Register after October 1 - $40
$40.00 Quantity



Additional Donation

Enter Desired Amount
$1.00 Amount
Item subtotal:$0.00



Total

$0.00
Select a T-Shirt Size
IMPORTANT: After submitting this form, you will see a Thank You page and at the bottom is a link to the Participation Release Waiver Form. You MUST fill out this online form and digitally sign it or you will not be able to participate in the Walk 2 Remember.

NOTE: If you have questions regarding registration, contact Brandi Johnson (865) 657-7222‬.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Walk 2 Remember Registration Form

You must select the date window that corresponds with when you are actually filling out and submitting this form.*

Payment Methods

You must select the date window that corresponds with when you are actually filling out and submitting this form.