The time is now to defeat ALS!

1.

Please include all of your contact information.

*

Name:

First Required	Last Required

*

Email: Required

*

Street 1: Required

Street 2:

*

City/State/ZIP:

City Required	State Required	ZIP Required

*

Phone Number: Required

Yes, I would like to receive e-mail from The ALS Association Minnesota/North Dakota/South Dakota Chapter

Keep me logged in. What's this?

*2.

Question - Required - Are you 14 years of age or older?

*3.

Question - Required - Have you volunteered for this event before?

4.

Question - Not Required - If yes, please list all volunteer duties you have done before.

(Maximum response 255 chars, approx. 5 rows of text)

*5.

Question - Required - Please select the time frame in which you would like to volunteer.
Please make at least 1 selection from the choices below.

	7am to 10am
	8am to 11am
	9am to 12pm
	11pm to 2pm
	Any Shift
	All Shifts

6.

Question - Not Required - Please list the first and last names of anyone you want to be grouped with. (We will do our best to assign people with their friends and families but we cannot guarantee that you will be grouped together.)

(Maximum response 255 chars, approx. 5 rows of text)

7.

Question - Not Required - Please list any special conditions or limitations that we should be aware of.

(Maximum response 255 chars, approx. 5 rows of text)

8.

Question - Not Required - If you are volunteering as part of a group or organization, please list the name here.

9.

Question - Not Required - If you registered another person, please provide an email and t-shirt size for them.

*10.

Question - Required - Do you plan to Walk?

CLICK HERE TO READ RELEASE AND WAIVER OF LIABILITY.

*11.

Question - Required - To express my understanding of this Release, select Yes.

Dayton Walk Volunteer Survey

CLICK HERE TO READ RELEASE AND WAIVER OF LIABILITY.

Thank You to Our National Sponsors

Our Local Sponsors

Dayton Walk Volunteer Survey

CLICK HERE TO READ RELEASE AND WAIVER OF LIABILITY.

Thank You to Our National Sponsors

Our Local Presenting Sponsor

Our Local Sponsors