26th Annual Memorial Walk-a-Roll-a-Thon / Illinois Spina Bifida Association

28th Annual Central Illinois Walk-and-Roll-a-Thon

Sunday, October 5th, 2025

Tipton Park, 2201 Stone Mountain Blvd., Bloomington, IL MAP

12:00pm Check-In, 12:30pm Walk-and-Roll, 1pm Lunch

Free lunch for all registered participants

Registration

Name of Person with Spina Bifida Attending (or Who You are Supporting)*

FirstLast

Name of Parent / Guardian, for Children with Spina Bifida

FirstLast

E-mail*

example@example.com

Phone Number*

Opt-In to Text Messages (Optional)

By checking this circle, you agree to receive text messages from the Illinois Spina Bifida Association at the phone number provided above. You may reply STOP to opt-out at any time. Reply HELP for assistance or visit www.i-sba.org. Message and data rates may apply. Message frequency will vary. Learn more on our Privacy Policy page (www.i-sba.org/privacy) and Terms and Conditions (www.i-sba.org/sms).

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Total Number of ADULTS attending*

Total Number of CHILDREN attending*

Dietary Restrictions, Comments or Questions (Optional)