Maddie's Miracles 1st Annual Walk-a-Thon
Event Timing: September 22, 2019, 9am-2pm
Event Address: Exeter High School, 201 E 37th St. Reading, Pennsylvania 19606
Contact us at info@maddiesmiracles.org with any questions.
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Address (Street, City, State, Zip) *
Phone Number *
Emergency Contact Information (Name, Phone, Relation to Participant) *
T-Shirt Size(for pre-registration due by September 8th) *
How did you hear about Maddie's Miracles?
Your e-signature below signifies that all the above information is correct and that you will participate in the walk-a-thon benefitting Maddie’s Miracles: *
Registration
Registration for this event is $20 for adults and $10 for participants under 18 years old. A t-shirt is included with the first 50 registrants. It is on a first come, first serve basis. Please mail registration fee to Maddie’s Miracles, 4970 DeMoss Rd, Suite 300, Reading, PA 19606.

Maddie's Miracles is a 501(c)(3) organization. Tax ID #: 83-3430588
Click here to pay registration fee: https://www.maddiesmiracles.org/donate/
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms