Registration Form - 2015 Kacie's Cause Mother's Day Walk
Use this form to register for the 2015 Kacie's Cause Mother's Day Walk. If you have questions before submitting your request, please contact Betsy Gillen, Parkesburg Chapter Director, at betsy.kaciescause@gmail.com.

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Walk Registration
Please enter your information below. (This info will not be made public.)
Your Name *
First & Last
Your email address *
In case we need to confirm anything, or provide you with additional information about the walk.
Your phone number
If you don't check your email very often, and we need to get in touch with you.
Please enter the names of other people coming with you. Please separate names with a comma.
Example: "Jack Smith, Jane McDonald, Mary Jones, Teddy Jones".
Do you have a team name for the walk? If so, tell us what you call yourselves.
No pressure on this one! An example team name could be "Walking for Good". If you don't have a team name, you can skip this question.
Did you participate in the 2014 Kacie's Cause Mother's Day Walk?
If yes, welcome back! If no, we're so happy to see you here!
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Please enter comments you wish to share with the Kacie's Cause Parkesburg Chapter Team
(Your comments will be kept confidential.)
THANK YOU for registering for the 2015 Kacie's Cause Mother's Day Walk. We are happy that you will be joining us for an enjoyable walk to remember and honor our loved ones.
Like and follow "KACIES CAUSE PARKESBURG CHAPTER" on Facebook page for news, updates and information.

***Please review that your information is correct, then click the "SUBMIT" button to complete your registration.***
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