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Brainstorming4Us.com

   Traumatic Brain Injury Support Group
   Serving the High Desert communities of Southern California 
   Apple Valley, Hesperia, Victorville & surrounding areas.
  
Walk for Thought
You are here  »  Walk4Thought  »  Register
Walk4Thought Registration

Please enter your billing Name and Address information.  All information will be sent to our secure payment processor.  You will be prompted for your credit card information on the next page.  Don't forget to click on the return to Brainstorming4us.com link to get your waiver and instructions!'

Step 1 - Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Email:
I am walking as:
Team Name: (Optional)
I/We are walking in Honor of: (Optional)
Note:Participant name(s) may be different than the person entering the information.
Participant 1 (All Fields are Required)
First Name:
Last Name:
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Shirt Size:



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This person will be donating blood
Participant 2 (Optional)
First Name:
Last Name:
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Shirt Size:



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This person will be donating blood
Participant 3 (Optional)
First Name:
Last Name:
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Shirt Size:



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This person will be donating blood
Participant 4 (Optional)
First Name:
Last Name:
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Shirt Size:



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This person will be donating blood
Participant 5 (Optional)
First Name:
Last Name:
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Shirt Size:



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This person will be donating blood
Participant 6 (Optional)
First Name:
Last Name:
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Shirt Size:



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This person will be donating blood
Proceed to Step 2 - Payment
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