Please fill out the form below, select what days and activities you would like to be involved with, then finish the registration by submitting the form and payment on the payment processing screen.

Walker, Volunteer and Donor Registration
First Name :
Last Name :
BirthDate :	Age :
Gender :	-- Select -- Female Male
Shirt Size :	-- Select -- Small Medium Large X Large XX Large XXX Large
Address Line 1 :
Address Line 2 :
City :
State :	- Select - HAWAII ALASKA ALABAMA ARKANSAS AMERICAN SAMOA ARIZONA CALIFORNIA COLORADO CONNECTICUT DISTRICT OF COLUMBIA DELAWARE FLORIDA GEORGIA GUAM IOWA IDAHO ILLINOIS INDIANA KANSAS KENTUCKY LOUISIANA MASSACHUSETTS MARYLAND MAINE MARSHALL ISLANDS MICHIGAN MINNESOTA MISSOURI MISSISSIPPI MONTANA NORTH CAROLINA NORTH DAKOTA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA PUERTO RICO PALAU RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA VIRGIN ISLANDS VERMONT WASHINGTON WISCONSIN WEST VIRGINIA WYOMING
Zip Code :
Phone :
Email Address :

Emergency Contact
Name :
Relationship :
Phone Number :

Fundraising Efforts

Getting involved in this event is the first step on our walk together. Helping us to raise money will make our long journey seem more like a walk in the park, just one fun step at a time. Please take this step and put your best foot forward ! YES! I want to help in fundraising.  I will try to raise :   - Select - - no fundraising - $ 50 $ 100 $ 150 $ 200 $ 250 $ 300 $ 350 $ 400 $ 450 $ 500 $ 550 $ 600 $ 650 $ 700 $ 750 $ 800 $ 850 $ 900 $ 950 $ 1000 $ 1050 $ 1100 $ 1150 $ 1200 $ 1250 $ 1300 $ 1350 $ 1400 $ 1450 $ 1500 $ 1550 $ 1600 $ 1650 $ 1700 $ 1750 $ 1800 $ 1850 $ 1900 $ 1950 $ 2000 $ 2500 $ 3000 $ 3500 $ 4000 $ 4500 $ 5000 $ 5500 $ 6000 $ 6500 $ 7000 $ 7500 $ 8000 $ 8500 $ 9000 $ 9500 $ 10000

AND, we can automatically create a page for you (see: "Sponsor a Walker") to help you achieve your fundraising goals. To see an example click here ! On your page you can upload a photo too so people can see your bright smile ! You can send your personal page link out to friends and make your fundraising effort a lot easier ! When friends visit your page they will see your name and fundraising goals, and a photo if you uploaded one. They will then be able to make a contribution right there on your page and save you time from having to find them later. It's REALLY convenient !

Can we create this page for you ? :    - Select - Yes - Create the page No

I want to make a personal donation now :    - Select - - no donation - $ 25 $ 50 $ 75 $ 100 $ 125 $ 150 $ 175 $ 200 $ 225 $ 250 $ 275 $ 300 $ 325 $ 350 $ 375 $ 400 $ 425 $ 450 $ 475 $ 500 $ 525 $ 550 $ 575 $ 600 $ 625 $ 650 $ 675 $ 700 $ 725 $ 750 $ 775 $ 800 $ 825 $ 850 $ 875 $ 900 $ 925 $ 950 $ 975 $ 1000 $ 1025 $ 1050 $ 1075 $ 1100 $ 1125 $ 1150 $ 1175 $ 1200 $ 1225 $ 1250 $ 1275 $ 1300 $ 1325 $ 1350 $ 1375 $ 1400 $ 1425 $ 1450 $ 1475 $ 1500 $ 1525 $ 1550 $ 1575 $ 1600 $ 1625 $ 1650 $ 1675 $ 1700 $ 1725 $ 1750 $ 1775 $ 1800 $ 1825 $ 1850 $ 1875 $ 1900 $ 1925 $ 1950 $ 1975 $ 2000

Registration Fee Waiver

This event is about Homeless Awareness. If you are homeless and want to participate, we want you involved ! We also understand that you may not have the $30 registration fee required. Here you can request a fee waiver. Please also notice the box above called, "Fundraising." You can use this option and try to help do fundraising for the event too. Help us, Help you !

I am homeless and want to participate. I am requesting a fee waiver

	Date - Destination - Distance.	I am Walking	I am Volunteering
	Day 1, Saturday, Nov 14th : Honolulu to Hawaii Kai - 10 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 2, Sunday Nov 15th : to Waimanalo - 12 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 3, Monday Nov 16th : to Kahalu’u - 14 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 4, Tuesday Nov 17th : to Laie - 18 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 5, Wednesday Nov 18th : to Haleiwa - 17 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 6, Thursday Nov 19th : To Yokohama Bay, through Kaena Point - 14 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 7, Friday Nov 20th : to Kapolei Fair Grounds (Across from Wal Mart) - 22 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 8, Saturday Nov 21st : to Aiea United Methodist Church - 12 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm
	Day 9, Sunday Nov 22nd : Final Day - to Honolulu - 11 miles	Yes	Yes  - Select - All Day Morning Only Afternoon Only 6am - 9am 9am - 12 noon 12 noon - 3pm 3pm - 6pm

By clicking on "I Understand and Accept the terms for 'Walk the Talk.' ", you agree, warrant and covenant as follows: I AGREE to comply with the rules and regulations, and the event instructions of WALK THE TALK. I UNDERSTAND that participating in one or more days of the 9-day-round-the-island walk maybe a potentially hazardous activity and can result in serious injury or death. I am aware of and I expressly assume all inherent risks associated with participating in this event, including, but not limited to the effects of weather, including high heat and humidity, traffic, and the conditions of the road. I acknowledge that it is my responsibility to be aware of my environment and surroundings at all times. IN CONSIDERATION of your accepting this entry, I for myself and anyone entitled to act on my behalf, waive and release from any and all claims for injuries and damages I may have against Walk the Talk, Hawaiian Hope, the City & County of Honolulu, State of Hawaii, the United States of America, Sponsors of the event, their agents and representatives arising out of my participation in this event, including pre walk training activities. I ATTEST that I am physically fit and have sufficiently trained for completion of some or all of the 9 day legs. I CONSENT to receive medical treatment which may be advisable in the event of illness or injuries suffered by me during this event, and I agree to pay for the costs of my medical treatment. I GIVE PERMISSION for the free use of my name, voice or picture in any broadcast, telecast, advertising promotion or other account of this event. Because of the proximity of walking near and on the road, No one under 10 is permitted on the walk. No One under 16 is permitted on the final leg of day 6 - Kaena Point.

I Understand and Accept the Terms and conditions for "Walk the Talk".