Registration Form

Clearfield Jefferson 9th Annual Walk
for Suicide Prevention & Awareness

Sunday, September 9th 2018
DuBois City Park on Liberty Boulevard

Please, fill out the form below to register.

If you want to Join an existing Team or create a new Team, choose a Team name or enter a new Team name below.

< 18 18 - 59 60 +
I accept.
I grant permission to Clearfield-Jefferson Suicide Prevention Team to use and publish pictures of me taken at the event (read full Photo Release).
I accept.
I waive and release any and all rights for damages I may have with the Clearfield-Jefferson Suicide Prevention Team Walk (read full Liability Waiver).

2018 Walk T-shirt

If you want to order the official 2018 Walk T-shirt:

  1. Select the checkbox below to confirm your T-shirt order.
  2. Pick a size.
  3. At the end of your registration, you will be redirected to Paypal to make the payment.
  4. The below prices are valid through August 22 and will increase by $5 on August 23. Deadline to preorder T-shirts is August 29, 2018.
    A VERY LIMITED AMOUNT OF T-SHIRTS WILL BE AVAILABLE AT THE WALK.
Walk t shirt 2018 f2b705b2844aaa56711f37dbcabb3017ef57cea0ddf2cc40dbb47d5b815806af

   Yes, I want a T-shirt
(Please, select a size below.)

Cost $5.00:

Small
Medium
Large
XL

Cost $7.00:

2XL
3XL

Cost $9.00:

4XL
5XL

You will be registered as an Individual.

If you want to join an existing Team, please click on "Join an Existing Team" above.

If you want to create a new Team, please click "Create a New Team" above.