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Online Registration

Register to Walk
* indicates a required field
Your First Name*:
Your Middle Name:
Your Last Name*:
Company Name:
Address*:
City*:
State*: Zip/Postal Code*:
Country*:
Telephone*:
Email Address*:
Fundraising Goal*:
Other Amount:
(optional)
$
If joining a team, please select one:
If you wish to create your own Walkathon team, you will have the option to do so in your Walker Log-in.
Adult Walker 31 and above = $50
Adult Walker aged 19-30 = $35
Walker age 18 and under = $20
Only Listen to Z100 Entertainment at Event (I don't want to walk) = $20
Platinum Walker = $500.00
(includes registration for 2 adults and up to 7 children)
Gold Walker = $350.00
(includes registration for 2 adults and up to 5 children)
Silver Walker = $250.00
(includes registration for 2 adults and up to 3 children)
I am a(n):
Additional Adults:
If you are including other adults in your registration, enter their names here.
ENTER ONE NAME PER LINE.
Additional Adults aged 19-30:
If you are including other adults in your registration, enter their names here.
ENTER ONE NAME PER LINE.
Children 18 & under:
If you are also registering to walk with children, enter their names here.
ENTER ONE NAME PER LINE.
 
Additional Contribution to PCF: $
YES! I would like to purchase a special "priceless" raffle. Prizes include special Mets, Knicks and Disney packages, a Berkshires getaway, a signed guitar and a $500 Jewelry Gift Certificate! CLICK HERE FOR MORE INFO
Select number of raffles @ $25/each:
Choose your desired prize:
If you wish to order tickets for more than one prize, you may do so by visiting
pcfwalk.org/sponsor/raffle.php after completing this transaction.
Your grand total will appear on the next page for confirmation.

Login*:
Choose a Password*:
This will enable you to log in and edit your personal Walkathon page.
Confirm Password*:
Optional Text for your Personal Page:
On your personal Walkathon page, you can write some optional text to encourage people to sponsor you, to note if you are walking in someone's honor, memory, etc. You will be able to change this text at any time.
You can choose to cover the service and credit card fees that come with online donating to ensure that this charity receives 100% of the value of your contribution.
Yes, add 3.5% so 100% of my donation goes to charity.
Add me to the Pediatric Cancer Foundation mailing list.
If you do not join our list, you will not get any other material from us except a receipt for your donation.
By submitting this form I agree to the terms of the PCF Walkathon consent form. Parents/Guardians must consent for any child under 18 years of age participating at this event.

Please note that registration fees are non-refundable.



For tax purposes, you will receive a receipt via email after submitting your payment.

In response to IRS regulations regarding charitable donations, we affirm that no goods or services have been provided to you in consideration of your gift.