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See you next year!

On-line Registration Form   

10th Annual Can Do Walk & 5K 

Sept. 8, 2012, 9am at Tower Park, Peoria Heights, IL

Name:    

Address: 

City:          

State:            Zip Code:

Email:      

Re-enter Email:      

Please select one:
2 mile walk
5K run

Please select one:
Individual ($30), if you bring matching gift form, only $20
Bring a Friend ($20)
Family ($60)
Team ($100) - teams are 10 or more people

Team/Family Registration - Only one person needs to register for the entire team/family
Please identify number of people on your team/family

Free T-Shirts for all pre-registered participants!

Note: only $20 registration fee if you bring the matching gift form from your employer.


T-Shirt Size: Total Needed:
Small
Medium
Large
X-Large

Bring contribution to the Walk and Run
(NOTE: Cash or checks made out to "Can Do", at this time we are unable to accept credit cards.)

Mail contribution to Can Do Scholarship Fund
        c/o Community Foundation of Central Illinois
        331 Fulton Street, Suite 310
        Peoria, IL 61602

Contribute ONLINE. (We encourage you to contribute online after you submit your registration form by clicking "donate now" on the next page.)

Contribution Amount: $

How did you hear about the Can Do Walk & 5K?  Note: if you bring a friend or team, we'll need them to sign a waiver before participating the morning of Sept. 10th.