Walk Registration

Thank you for your support. Please complete the required (*) information OR print the form and follow accompanying instructions.

Deadline to order t-shirts April 24, 2017 MIDNIGHT

Check with your employer to see if your business participates in a matching donation program.

For more information, please call 800-808-7437 or email caring@peds.umaryland.edu.



* Required Field

Billing Information
Matching Gifts
Yes
No
Team Information
YES NO
YES NO
Registration

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Waiver
I hereby waive all claims against the CICL, University of Maryland School of Medicine, UMB Foundation Inc. and all event sponsors and personnel for any injury that may occur to me.
I attest that am I physically healthy and can walk this event.
I grant permission to the UMB Foundation to print photographs of me.
There is a problem with the form. Please correct the marked field(s) and resubmit.