Walk-a-Thon Registration Info

Thank you for registering.
We look forward to walk a mile or two with you!

Please provide us some information about you.

[contact-form to=’subscriptions@6beds.org’ subject=’6Beds Walk-a-Thon Registration’][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Mobile | Contact Phone’ type=’text’ required=’1’/][contact-field label=’Register As’ type=’radio’ required=’1′ options=’Non-Member ($65),Member ($50)’/][contact-field label=’Mailing Address’ type=’text’/][contact-field label=’City’ type=’text’/][contact-field label=’Zip’ type=’text’/][contact-field label=’Comment’ type=’textarea’/][/contact-form]