Walk for Parker Registration Form.

Walk for Parker 2025 Registration Form

Please fill out your information below to register for this event.
PLEASE READ CAREFULLY

First off, we want to say thank you so much for wanting to participate in the Walk for Parker. Our family is so grateful and honored that you are helping us raise money for Molly Bears and to give other families the comfort they need the most during such a hard time. With that said, please read the below agreement and rules before signing up. Thank you!

By Signing Up Below I/We understand:

-This is a 501c3 non-for-profit charity event, and all proceeds will be donated Hand to Hold, Little Giraffe Foundation, A Butterfly's Journey, and towards Parker Memory Bags.

-Entry fee is $45 per person [early bird entry, now till Sept. 1st]. And $50 per person [after Sept. 1st]. Children 12 and under are free.

-If you register after September 12th, t-shirts are not guaranteed.

-This event takes place on Saturday, October 4, 2025.

-This is a 3k walk/5k run event to be held at Jaycee Memorial Park, located at 1050 Wilmot Road, Deerfield, IL, 60015.

-The event starts at 9am, rain or shine.

-All participants must be checked-in between 8am-9am, before the race begins at 9am at Jaycee Memorial Park.

-At check-in, each paying participant will receive a t-shirt and 3 raffle tickets. And after the event, there will be a hot breakfast, refreshments, kids activities and more available for no additional cost.

-Pets are welcome. Please respect our community and make sure to pick up after them and they must be kept on a leash at all times.

-Strollers are allowed.

-No electric scooters allowed.

-No adult bicycles allowed. Children bicycles are ok.

-Participants that are 12 years of age and under are free to attend the event, along with all pets that will be walking.

-If you would like to purchase a t-shirt for your child that is 12 and under, you may for an additional cost. More information is at the bottom this form.

-All participants participating in the Walk for Parker are attending on their own will, therefore, if any injuries do occur during this event, The Deerfield Park District and the Walk for Parker, are not responsible.

-I, the participant, is responsible for those that are under the age of 18 years of age that I bring to this event, i.e. children and pets.

-Those that are not participating are very welcomed to come and watch and show their support by cheering you on.

Thank you so much, The Operzedek - Meyer Family

____________________________________________________________________________
Section A: Primary Participants Information
Is this your first time participating in the Walk for Parker?*

YesNo
Primary Participant's Name*

First NameLast Name
Birthdate*

MonthDayYear
Home Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail Address*
Which race are you participating in?*
Walk for Parker T-Shirts:

We ask all participants to wear a WFP t-shirt (old or new) to the event. New participants please make sure to selet yes for a shirt. If you are a returning participate, you have a choice to either wear an old WFP shirt or get the new 2025 shirt. Please indicate below what your choice is.

___________________________
Would you like a 2025 WFP Shirt?*
If yes, what size t-shirt?
Section B: Additional Participants
Number of additional family members (including yourself) participating in this event that are over the age of 12.*
Please INCLUDE yourself
Please fill out the names of the additional participates/family members participating in this event below. DO NOT include yourself & DO NOT include those that are 12 years old and under.

____________________________________________________________________________
Participant 1

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 2

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 3

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 4

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 5

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 6

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 7

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 8

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 9

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
____________________________________________________________________________
Participant 10

First NameLast Name
Birthdate

MonthDayYear
Which race are you participating in?
Would you like a 2025 WFP Shirt?
If yes, what size t-shirt?
Section C: Children 12 and Under

Please fill out the questions below.
Are there any children 12 and under, in your family, that will be participating in this event?*
If yes, how many?
Please fill out how many total children 12 and under that will be attending
Please enter ALL the children 12 and under that will be participating by entering their first and last name in the box(es) below.
Child #1
Child #2
Child #3
Child #4
Child #5
Child #6
Note *If you wish to purchase any additional t-shirts for your child/children for an additional price, you may add them to your cart at the bottom of this form.
Section D: Pets

We would like to get a head count of how many pets will be participating.
Are you bringing any pets to this event to participate with you?*
If yes, how many?
Section E: Raffle

If you are interested in purchasing additional raffle tickets, you can do so here.
*Each paying participant will recieve 3 raffle tickets. You can purchase additional raffle tickets here.

This year's raffle includes:

-Gift Certificant & chef hat from Taste Buds Kitchen (https://tastebudskitchen.com/bannockburn/)

-The Morton Arboretum

-Marrott Theatre

-Gift Certificant to Puttart (www.puttart.com) - personalized stationary

-Gift Certificant to PixieLane Kids by Dayna (www.facebook.com/pg/pixielanekidsbydayna) - children's clothing

-More to Come! ___________________________________________________________________________________________________
3 tickets for $5
5 tickets for $7
10 tickets for $10
Your Total $
Section F: eSignature

Do not e-sign until you have read and understood the above rules and regulations.
By my eSignature below, I certify that I have read, fully understand and accept all terms of the foregoing statement. Please signify your acceptance by entering your full name in the box below.*
Please type your full name
Waiver of Liability Signature*

I accept the terms listed in the agreement above
Section G: Additional Add-Ons

Do you wish to make a donation or purchase additional t-shirts or bracelets?
If you wish to make any additional donations to Walk for Parker, please enter a dollar amount below.
____________________________________________________________________________

If you wish to purchase any additional WFP t-shirts, please enter the total number of each t-shirts below.

*Note: Here is where you can purchase a t-shirt for your child or a friend.

Each t-shirt costs $20.00.

____________________________________________________________________________
Adult Women's Small
Adult Women's Medium
Adult Women's Large
Adult Women's X-Large
Adult Men's Small
Adult Men's Medium
Adult Men's Large
Adult Men's X-Large
Your Total $
____________________________________________________________________________

If you wish to purchase any additional drawstring bags, please enter the total number below.

Each bag costs $6.00.

____________________________________________________________________________
Bags
Your Total $
____________________________________________________________________________

If you wish to purchase any bracelets, please enter the total number below.

Each bracelet costs $2.00.

____________________________________________________________________________
Blue Bracelets
Red Bracelets
Your Total $
Section H: Check-Out

Please review final information and enter payment.
Entry Fee Total $
Additional Raffle Tickets $
Additional T-Shirts $
Additional Bracelets $
Additional Bags $
Additional Donations to Walk for Parker $
Your Final Total $
*PLEASE REVIEW YOUR FINAL TOTAL ABOVE AND ENTER IN THAT AMOUNT INTO THE FINAL TOTAL BOX BELOW. (POWERED BY PAYPAL)
Your Final Total $*

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USDThis is a donation for the Walk for Parker. We are a non-profit organization.
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Walk for Parker 2025 Registration Form

Section A: Primary Participants Information

Section B: Additional Participants

Section C: Children 12 and Under

Section D: Pets

Section E: Raffle

Section F: eSignature

Section G: Additional Add-Ons

Section H: Check-Out