Test New Reg. Form

"*" indicates required fields

Your Name*

First Last

Your Email*

Enter Email Confirm Email

Your Phone*

Your Address*

Street Address City State ZIP Code

Fundraising Story

Why are you walking and raising money for Loaves & Fishes? This message will show with your donation form to inspire your sponsors to support your walk.

Photo

Optional – Please submit an all age friendly, appropriate photo to represent you or your team. Loaves & Fishes will have all rights to use this photo to promote the walk, promote your donation form and for general news and website use after the walk. You must have the permission of all who appear in the photo. Photo should be a maximum of 2048px X 2048px, 72dpi/ppi and in jpg format. Maximum file size is two megabytes.

Accepted file types: jpg, jpeg, Max. file size: 2 MB.

Fundraising Goal*

What is your fundraising goal for the walk? Your fundraising can come from a personal donation and from family, friends and other sponsors.

Please enter a number greater than or equal to 25.

Team

Select or create a team, if applicable. You do not need to be part of a team to participate. If you are walking with a team, we can track your collective fundraising towards a team goal in addition to your individual fundraising.

Team

If you are walking with a team, please select it here. Choose “Create a new team” if you need to create a new team and you are the captain of that team.

Team Name*

Give your new team a name.

Team Description

Tell us briefly about your team. What brought you together to raise funds for Loaves & Fishes? We may use your story in our efforts to promote the walk.

Team Fundraising Goal*

What is the goal for your team? Please enter a number that is at least 25.

Please enter a number greater than or equal to 25.

Your Entry Donation Payment

Entry Donation*

Please make an initial donation of at least $25 to register.

Price:

Additional Donation

If you’d like to donate more than $25, enter the additional amount here.

How would you like to pay?

Credit Card

Mail a Check

Would you like to cover the processing fees for your donation?

If you’d like your full donation to go to feeding our neighbors in need, check the box to cover the credit card processing costs for your donation.

Yes, I will pay the processing fees.

Processing Fee

Price: $0.00

Total Donation

Credit Card

After submitting this form, please mail a check for your total donation made out to Loaves & Fishes. Write “Spring Into Action 5K” in the memo field and mail to:

Loaves & Fishes
P.O. Box 1
Ayer, MA 01432

confirm

Phone

This field is for validation purposes and should be left unchanged.