Autumn Walk Registration Sign up to join us for the Autumn Walks and pledge a donation! If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Which Autumn Walk will you be attending? Owensboro Evansville Register for the Autumn Walks Team walker/Individual Walker Mega Supporter- I will be attending the walk & raising money Marching in Spirit- I can't attend the walk, but will be there in spirit Mighty Survivor- I have MS and will be attending the walk Team Name (If applicable) After completion of this form, you will be directed to the Tri-State MS Association's PayPal where you can donate your pledged amount. Donations will also be accepted at the Autumn Walks. Please select a donation level. $50 - Autumn Walk T-Shirt $75 - Autumn Walk T-Shirt & Gift Certificate $150 - Autumn Walk T-Shirt & Gift Certificates $250 - Autumn Walk T-Shirt & Gift Certificates $500 - Autumn Walk T-Shirt & Gift Certificates Other * I will not be donating at this time or will bring donation to walk If you selected Other, please enter your donation amount below: I will be paying for my registration by: PayPalAt the Autumn WalkMailing in DonationNot Applicable If you donated at $50 or more, please select a T-Shirt size. Small Medium Large X-Large XX-Large First Name * Last Name * Address 1 * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Email Phone Total