Ready to run or walk? Register below. "*" indicates required fields This form is to register for the walk and participate with TeamJeff! If you got here by accident, and only want to donate, click here to Donate to TeamJeffRegistration FeeRegistration Fee is $30 per person. If only one person is registering, your information is taken below. You are Person 1. The person completing the registration will also accept the walk waiver before completing the form. 1 Person – $30 2 People – $60 3 People – $90 4 People – $100 Team “Special” Pricing! Person 2Please provide the name of the second person being registered.Person 3Please provide the name of the third person being registered.Person 4Please provide the name of the third person being registered.We need more information….Name*This person is the contact person for this registration and person #1 if multiple registrants. 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 StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest 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 Comments to TeamJeff!Show some team support! (It will be displayed on the website!)Total This is the total amount for your registration or donation. As you make additional choices your total may change.Consent*Waiver (Read before completing this registration.) I know participating in this event is a potentially hazardous activity. I will not enter and participate unless I am medically able. I agree to abide by all rules and stay on the route. I assume all risks associated with this event, including but not limited to falls, contact with other participants, effects of weather including high heat and humidity, all conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Achievement Center of Texas, the City of Garland, participants, volunteers, and all sponsors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, recordings or any other record of this event for any legitimate purposes. This waiver is accepted by all persons registered on this form. I agree to the waiver.Credit Card*Card Details Cardholder Name NameThis field is for validation purposes and should be left unchanged. TeamJeff TeamJeff We have received 0 registration(s) to walk totaling $0 Don't want to walk/run? Click here to make a donation! No entries match your request.
