2024 Child Loss Awareness Walk Registration Name(Required) First Last Phone(Required)Email(Required) Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How many kids under 8?(Required)How many kids ages 9-17?(Required)How many adults (ages 18+)?(Required)Total Number of Memberships + Price(Required) Price: $200.00 Runners' Information(Required)Please add a row for each runner you are registering. Name (First and Last)AgeT-Shirt Size *while supplies last* Add RemoveOther Requests/CommentsConsent(Required) I agree to receive other communications from High Point Rockers. CAPTCHA