Walk4Duchenne 2027 - Casual Walker

Walk4Duchenne 2027 - Casual Walker

Please complete all required fields. Information provided will be kept confidential andused solely for event organization and participant safety
- Title
- First Name
- Last Name
- * Please provide full name as it would appear on your driver’s license or passport.
- Date of Birth
  
  DayMonthYear
  2 digit day, 2 digit month, 4 digit yearDate
- Mobile Number
  Please enter a valid phone number.Format: (+61) 000 000 000.
- Email Address
  example@example.com
- Company Name (if applicable)
- Are you a Chemist Warehouse employee?
- In which state?
- Emergency Contact - Full Name
- Relationship
- Mobile Number
  Please enter a valid phone number.Format: (+61) 000 000 000.
- Email Address
  example@example.com
- Men's Shirt Size
- Women's Shorts Size
- Youth Shirt Size
- * Ladies may select larger men’s sizes if preferred, sizes run true, we recommend ordering a size up from your normal size if you want a less fitted shirt. Limited spare sizes will be available on site.
- Do you have any medical conditions which may affect you during the walk? (leave blank if no)
  *This information shall remain confidential and is solely required for the purpose of preparing for the safety & wellbeing of all participants.
- Do you have any dietary requirements or specific food allergies? Please outline them here (leave blank if no)
- Are you qualified in first aid, or have sound knowledge of first aid and/or resuscitation?
- Please provide details of your first aid experience and qualifications
- Name of fundraising page
  This can be your first and last name, family name, company name or a name of your choice. Please keep it short and avoid special characters, as this name will be visible on your fundraising page.
- Reason why you are walking?
- Photo of Walker/s
  
  Accepted file formats: JPG, JPEG, PNG - Maximum file size: 5MB
  Cancelof
- Fundraising Target
- Other Target
- To participate in the 2027 Walk4Duchenne we require all entrants to accept the terms and conditions as set out in the linked 2-page document. Please read these terms and conditions before accepting. Should you have any questions or concerns regarding the indemnity waiver or the general terms and conditions, please contact us at events@saveoursons.org.au
- Should be Empty: