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  Join Us!!


PRINT THIS FORM, FILL IT OUT AND MAIL, WITH YOUR CHECK OR MONEY ORDER TO THE ADDRESS LISTED BELOW.

Included in your registration fee is a t-shirt, the Friday and Saturday night campground fees, Saturday night dinner, Sunday morning breakfast , Sunday afternoon BBQ, and all the water and snacks during the walk.

If you are a visitor to the park, you will be responsible for the National Park fee, the pool fee,  and your own breakfast Saturday morning  before the walk.

 
   
VOLUNTEER: walker support, first aid help, setting up diner & camp, preparation work, Stove Pipe Wells cookout help; prep work -- No additional charge
T-SHIRT PURCHASE ONLY: $15.00 + $5 shipping
WALKER REGISTRATION : $30.00 (includes T-shirt -- pick-up at walk)
   
Select T-shirt (adult) size: S    M    L    XL    XXL
     
    List names to include on the scroll, or any additional information or comments:
   
   
   
     
 
  Billing Information
Shipping Information
Required items are marked with an *   Same As Billing

* First Name:

* First Name:
* Last Name:
* Last Name:
* Address:
* Address:
Address 2:
Address 2:
* City:
* City:
* State/Province:
* State/Province:
* Zip/Postal Code:
* Zip/Postal Code:
* Country:
* Country:
E-Mail Address:
    
Daytime Phone:
   
         
 
Payment Information
  PRINT this form and send it, with your check or money order to:
 
 
 
Life Walk Registration
 
ATTN: Sharon Funck
   
PO Box 578
Death Valley, CA 92328
       
         
© 2007-2011 Death Valley Walk for Life    
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