2025 PI RAK Registration Form

Kindness Ambassador Registration Form

Join us for Random Acts of Kindness Day!! An amazing day filled with SMILES 😊, HIGH-FIVES✋ and random acts of AWESOMENESS and KINDNESS
Event Date: Saturday, July 12, 2025

Event Time: 10am to 4pm

Event Address: Walking event in London, ON

Starting location: The MYLIE Group Community Hub ~ 171 Wortley Rd. London, ON
Participant Information
Name*

First NameLast Name
Email Address*
example@example.com
Contact Number*
Please enter a valid phone number.
I am in for an amazing day filled with SMILES 😊, HIGH-FIVES✋ and random acts of AWESOMENESS and KINDNESS!!!!*

Yes!!!!No, next time
Ideal t-shirt size:
Will you be bringing others with you?

YesNoMaybe
Returning participant? Bring a mini crew of Kindness Ambassadors* and lead them on event day as a Kindness Captain! Sign me up to be a Kindness Captain!!

YesNo
How many OVER the age of 12 yrs old?
How many UNDER the age of 12 yrs. old?
Please use this LINK to invite the other participants to complete their registration form.
Would you like to be kept updated about upcoming events put on by and/or sponsored by Project IMPACK?

YesNo
Please verify that you are human.*
Should be Empty:

Kindness Ambassador Registration Form