Suicide Survivors Remembrance Walk in Kansas City

Remembrance Walk Registration

Step 1 of 2

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Age(Required)

How did you hear about this event?

Number of people you are registering?(Required)

Including yourself, how many people are you registering? You may register up to 5 people at one time.

Pre-Registration Total

Price: $25.00

Your Shirt Size(Required)

Registration #2 Name(Required)

Registration #2 Shirt Size(Required)

Registration #3 Name(Required)

Registration #3 Shirt Size(Required)

Registration #4 Name(Required)

Registration #4 Shirt Size(Required)

Registration #5 Name(Required)

Registration #5 Shirt Size(Required)

Name of Loved One

If you would like a name read at the closing ceremony of the walk, please include it here.

$25 per Walk Participant - Pre-Registration

$35 per Walk Participant - Standard Registration

Registration Total

Select Payment Method(Required)

MasterCard

Visa

Card Number Expiration Date Security Code

Schedule