If you do not want to participate in the walk, but would like to donate, click on the Team Fox button on the right.

Registration:

To register to walk please fill out the form below

Team Name (if applicable):
Walker's Name:
First:  Last:

Address:
Street:  City:

State:  Zip:

Phone:
Home:--  Work:--

Email:

Shirt Size:
M    L    XL    XXL    XXXL   

Please send a check or money order to:
Put The Fire Out For Parkinson's
P.O. Box 1719
Camarillo, CA 93011-1719