Walk A Mile in Her Shoes Walker Sign-up Form

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If you are in need of the envelope with the donors that you are able to get to sponsor you to walk please come into the Domestic Violence & Sexual Assault Center on 1050 Memorial Drive in Idaho Falls. You can also download the form here: https://drive.google.com/file/d/1QnhrZZnt56mx7NfF8fplRFNNQEaL3_I6/view?usp=sharing

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Email *

Name: *

Phone: *

Email Address: *

Do you understand that a minimum of $45 in donations is required to register for the event ($35 for students and $25 for children, age 10 and under). *

Yes

Is the individual walking an: *

Adult or child over 10

Child (10 and under)

Student

Reminder if additional members of your family are walking please complete this form for each family member. ( Do not need to answer)

Yes

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