First Name*

Last Name*

Date of Birth*

Gender (Optional)

Address*

City*

State*

Zip Code*

Phone Number*

Email Address*

Name*

Relationship*

Phone Number*

Team Name (if applicable)

T-Shirt Size Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XLAdult 2XLAdult 3XLAdult 4XL

Support children impacted by hair lossSupport children in foster careSupport cancer warriorsSupport alopecia awarenessSupport community wellness

Other Reason

I acknowledge that participation in the Crown Care Hair Walk involves physical activity and may carry certain risks. I voluntarily assume all risks associated with participation and release The Walker Foundation, its officers, directors, employees, volunteers, sponsors, partners, and event venue from any liability for injuries, damages, losses, or claims arising from my participation. I grant permission to The Walker Foundation to use photographs, videos, and recordings taken during the event for promotional, educational, and marketing purposes without compensation. I certify that I am physically able to participate in this event.

I acknowledge and agree to the Waiver and Release of Liability.

Participant Signature*

Date*

Parent/Guardian Signature (if under 18)

Guardian Date

Other Donation Amount

Event Date

Location

Check-In Time

Walk Begins

For more information:
📞 (816) 673-1325
📧 info@thewalkerfoundation.org.com
🌐 The Walker Foundation �

Thank you for helping us support children and families while raising awareness, confidence, and hope throughout our community. 👑