Register for the CPC Life Walk

THANK YOU FOR BEING A WALKER!

Please fill out the ENTIRE registration form below. When you are done, you will be provided with a link to your walker profile page. Share that link with prospective donors so they can donate online!  NOTE: Your full name, phone number (in case a sponsor would like to talk to you about your walk), profile picture, and goal will be displayed on your public profile page. All other information you provide is for office use only.



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<18 18+














(Whole dollar amounts only, no decimals)

* Required Field