Walk to Remember Registration
Honoring Pregnancy and Infant Loss, Mobridge SD 9/28/2025
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How many people will be joining you at the walk?
*
Paper bag lanterns will be placed around the track for the walk to honor the babies lost. If desired please leave the name and date of a child you would like placed on a lantern. Ex: Baby Jones 1/1/2011, or John Smith 1/1/2011
Submit
Optional T-Shirts (Order by 9/1/2025)
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( X )
Optional Adult T-shirt
Optional t-shirt for purchase, price will go to the cost of the shirt and payment for refreshments and lanterns at the walk
$
20.00
Size
Quantity
Price
XS
1
2
3
4
5
6
7
8
9
10
$
20.00
S
1
2
3
4
5
6
7
8
9
10
$
20.00
M
1
2
3
4
5
6
7
8
9
10
$
20.00
L
1
2
3
4
5
6
7
8
9
10
$
20.00
XXL
1
2
3
4
5
6
7
8
9
10
$
22.00
XL
1
2
3
4
5
6
7
8
9
10
$
20.00
XXXL
1
2
3
4
5
6
7
8
9
10
$
22.00
Optional Youth T-shirt
Optional youth t-shirt for purchase, cost will go to price of shirt, refreshments and lanterns at the walk
$
16.00
Size
Quantity
Price
XS
1
2
3
4
5
6
7
8
9
10
$
16.00
S
1
2
3
4
5
6
7
8
9
10
$
16.00
M
1
2
3
4
5
6
7
8
9
10
$
16.00
L
1
2
3
4
5
6
7
8
9
10
$
16.00
XL
1
2
3
4
5
6
7
8
9
10
$
16.00
XXL
1
2
3
4
5
6
7
8
9
10
$
18.00
XXXL
1
2
3
4
5
6
7
8
9
10
$
18.00
Item subtotal:
$
0.00
Should be Empty: