2020 ACTion Walk - Individual Registration or Donation I want to participate in the virtual walk! Teams are found on the Virtual ACTion Walk Team Portal Page.Choose your participation!*Support Team ACT by walking or making a donation, choose one to get started. Note: If you change your selection after beginning the form, your total will reset to zero, so please re-select your people count or re-enter your donation. I want to donate! I want to walk solo! Walk registration is closed. To continue, please click on "I want to donate!".!Virtual Registration FeeHow many people? Fee is $25 per person. 1-$25 2-$50 3-$75 4-$100 5-$125 Do you want a swag bag?*Swag bags will be available for pickup at the center (2950 N. Shiloh Rd., Garland, TX 75044) on Friday 10/23 from 5-8 p.m. This is a drive through event. Please stay in your cars. If you choose "No" your bag will be donated to a student. Yes No No, but I'd love to have mask(s). ----->I'll pick up my swag. ----->Please donate my swag to an ACT student. ----->Your mask(s) will be mailed to the address given at checkout. DonationEnter donation amount. Do you want a free mask if your donation qualifies?Donations of $25 or more receive a limited edition ACT face mask. If you choose "No" your mask will be donated to a student or staff. Yes No How will you receive your mask?You chose "Yes!" How do you want to receive your limited edition ACT mask? Please send my mask to the address provided on this form at checkout. We need more information....Name* First Last Recognition NamePlease enter the name you want to use for recognition on the website. If you wish to be anonymous, type Anonymous. Address* Street Address City State Your StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code CompanyIf this is a corporate sponsorship or tickets are being purchased by a company or organization, please provide the name here. Phone*Please provide a telephone number (cell number preferred) so we can contact you if additional information is needed.Email*Please provide the email address for the contact person. We will use this email address to communicate with you about your registration. Please check the box below if we can use this email address for other projects. Note: If you are already on our email list, checking no will not remove your email but you can use the unsubscribe link on emails from us to be removed. Future Email Use Consent*We would like to send occasional emails about activities and events to the email shown above. We do not share, sell or lease your information. You will always be given the option to opt out of future emails. Yes No Cheering Comments!Comments will be displayed on the website!Total $0.00 This is the total amount for your registration or donation. As you make additional choices your total may change.Payment Method* Select One Credit Card Credit Card*Card Details Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.
