Moonlit Memory Walk 2020 Registration Form

Moonlit Memory Walk 2020 Registration Form

Please fill out this form as completely as possible.
Need more details? Go to our event website https://www.moonlitmemorywalk.org/
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Where will you walk?*
GTA (Toronto), Niagara, Cambridge, Ottawa or Hamilton
Photo (500 or more pixels wide)

Upload a Photo
Upload a picture of who you will be walking in Memory of Cancelof
Photo (500 or more pixels wide)

Upload a Photo
Upload a picture of who you will be walking in Memory of Cancelof
Photo (500 or more pixels wide)

Upload a Photo
Upload a picture of who you will be walking in Memory of Cancelof
Walking for:*
Ex: my mom, my grandfather
Their Name:*
Please type their full name
Leave a written tribute:
Write a tribute you would like to share in Memory of your Loved One.
Working Paper (PDF or Word):

Upload a File
If you have written your tribute in a document (Submit here) Cancelof
Are you walking as an Individual or part of a team?*

IndividualTeam
Write down the name of your team members if it applies.
Team Member in Charge:
only if you are a part of a team

Toronto Location

TBD

Hamilton-Halton Location

TBD

Waterloo Wellington

TBD

Niagara Region

Heartland Forest

Ottawa

TBD