2017 Just 'Cause Breast Cancer Walk Registration
The 3-Day walk will take place June 2-4. All registrations for Just ‘Cause and Just 'Cause Journey must be received by April 1, 2017.
Last Name
Your answer
First Name
Your answer
Mailing Address
Your answer
Phone #
Your answer
Cell Phone #
Your answer
Email Address
Email communication regarding the Just ‘Cause Walk will be managed using the justcausewalk2017 google group. Email communication regarding the Just 'Cause Journey walk will be managed using the justcausejourney google group.
Your answer
Date of Birth
Your answer
Emergency Contact Name
Your answer
Relationship to Walker
Your answer
Emergency Contact Phone #
Your answer
Emergency Contact Secondary Phone #
Your answer
I plan to walk:
Please check your choice. If walking Sections, please use the next question to indicate which sections you will be walking.
Sections you will walk
Note: complete this only if you are walking various sections of the walk, rather than all 3 days, or Virtual Walk, or Just 'Cause Journey
Walker Registration Fee
Registration fees may be paid by check (send a check made out to Just ‘Cause to P.O. Box 132 Bolton, MA 01740) or online at our website. If paying the registration fee online, please add $3 to cover processing fees.
I would like to order the Just 'Cause t-shirt (included with registration fee):
If under the age of 18
Those 12 or older as of June 3, 2016 can walk a single section accompanied by registered walker who is a parent or legal guardian. Name, phone, and email of parent or guardian who will be accompanying:
Your answer
Fundraising for Just 'Cause
Walking in Just ‘Cause carries a commitment to raise at least $1,000 by May 15, 2017 whether walking 3 days, one (or more) sections or virtually. Additional fundraising is wonderful and very much appreciated by our recipient organizations. Walking in Just ‘Cause Journey does not carry a specific fundraising commitment but we hope that you will fundraise and donate in support of our recipient organizations.
Required
Waiver of Negligence and Release of Liability
I have read and agree to the waiver of negligence and release of liability found in the registration form and posted on www.justcausewalk.org/walk.html
Required
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