Registration Form

Registration Application

Step 1. Your Registration Involvement
I AM REGISTERING AS A WALKER (Please identify what type of walker below)		Check box to select your choice.
I will be a independent walker.
I am joining the Orlando & Wild 98.7's Morning Freak Show.
I am joining Fisher & Boy 97X team.
I am joining an existing team:		(Team Name)
I am forming a team and will serve as Captain:		(Team Name)
**For team Captains Only*, check this box if you agree with Team Captains Agreement:		(Read Captains Agreement)
I AM REGISTERING AS A CREW MEMBER.		Crew member is a two day commitment. All crew members are required to attend Crew Day on Friday before event. Crew members must be at least 18 years old. (Read Crew Member Agreement)
I AM REGISTERING AS A VOLUNTEER.		Volunteering is an easy and rewarding way to become involved with the TD Cassaway Walk. (Read Volunteer Agreement)
Please select any additional involvement you would like to participate in.
I am interested in finding a team to join.		Check box to select your answer
I am interested in assisting with fundraising.

I would like to volunteer for other Winky Wright Foundation events in the future.

Step 2. General Information
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:
Email: (Nearly all events communications will come via email.)		Providing a valid email address is crucial.
Confirm E-Mail:
T-Shirt Size: S M L XL 2XL 3XL 4XL
Are you a breast cancer survivor? (Yes / No)
How did you hear about the TD Cassaway Walk?

Step 3. Waiver Liability and Photo Release Boxes must be checked in order to participate.
I have read and accepted the terms of the *Waiver and Release of Liabilty*. (Check Box If Agreed)		Waiver and Release Liability Agreement
I have read and accepted the terms of the *Photo Release*. (Check Box If Agreed)		Photo Release Agreement
Step 4. Registration Fee
Upon submission of this Registration Application, you will be re-directed to our Payment Processing for final registration. Please note that your registration is not complete until payment has been paid and you recieve a payment confirmation from Paypal.