NFB of Minnesota Walk for Opportunity Entry Form
Thirty-eighth Annual WALK FOR OPPORTUNITY
10 Kilometer Walk, Run, Bike or Skate
Saturday, September 14, 2019
Starting Time: 10 a.m.
Start/Finish: Three Links Shelter at Silver Lake Park, 840 7th Street NE, Rochester
All participants are asked to raise at least $25 and turn in the contributions on or before the day of the walk.
Submit this form by September 2, 2019.
By submitting this form, I indicate my understanding that all monies collected in the name of the National Federation of the blind of Minnesota will be sent to the National Federation of the Blind of Minnesota, Walk for Opportunity, 100 E. 22nd St., Minneapolis, MN 55404, and that the National Federation of the Blind is not responsible for damages or injuries to me. If the participant is under 18 years of age, this Entry Form must be completed by parent or guardian.
Email address *
Name of Participant *
Your answer
Phone Number *
Your answer
Bus reservation *
Would you like to reserve a seat on the bus from the Metro area? Write in "yes" or "no."
Your answer
Lunch *
Lunches cost $8, to be paid on the day of the walk. Write in your sandwich choice here; if you do not want a lunch, write "none.". Choices are turkey, ham, tuna salad, egg salad, or veggie.
Your answer
Cheese? *
Would you like cheese on your sandwich? Write in "yes" or "no".
Your answer
Shirt Size? *
For your shirt size, write in small, medium, large, xl, xxl.
Your answer
Emergency Contact Name *
Write in the name of the person to contact in case of emergency.
Your answer
Emergency Contact Phone Number *
Write in the phone number of the person to contact in case of emergency.
Your answer
Emergency Contact's Relationship to You *
Write here whether the emergency contact is a parent, sibling, relative, friend, spouse, etc.
Your answer
Name and phone number of parent or Guardian, if applicable
If the participant is under the age of 18, the parent or guardian's name and phone number must be entered here.
Your answer
A copy of your responses will be emailed to the address you provided.
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