2026 Mental Health Awareness Walk Registration Form

2026 Walk Registration Form

Come on out and walk with us on Saturday, May 16th! Please provide the requested information below to register. You may register up to 4 walkers using this one form. Please submit an additional form if you need to add more. You will receive a copy of this form along with Walk Day instructions via email. Thank you for helping us WALK IT OUT for Mental Health Awareness!

2026 Walk Locations:

Lehigh Valley, PA - Cedar Beach Park 2600 Parkway Blvd, Allentown, PA 18104
Conyers, GA - Johnson Park 1781 Ebenezer rd, Conyers, GA 30094 Washington, DC
Preventive Measures 2124 MLK Jr Ave SE Washington, DC 20020 Washington, DC
Preventive Measures 702 15th Street NE Washington, DC 20002

Walk Location

Phone Number

Format: (000) 000-0000.

Email

example@example.com

Walker #1

Yourself

Walker #2

Walker #3

Walker #4

Walker #5

Note: This year, for every $25 donation you make, you will receive 1 walk t-shirt.

I plan to make a donation to receive at least 1 walk t-shirt.

Liability Waiver

By submitting this registration form I understand and agree that my participation and the participation of anyone I have listed above is voluntary and that I/we are responsible for the safety of myself and any of my/our associated participants. By signing below, I agree that I have the consent of the listed participants and that I/we release Preventive Measures/The PM Foundation from any and all liability that could arise from my/our participation in this event.

Signature*

Questions?
Please email Paula Gonzalez at pgonzalez@thepmfoundation.org.

Your Name