ALS Network

2024 Walk & Roll to Cure ALS Preregistration

Are you interested in joining one or more of ALS Network’s Walk & Roll to Cure ALS events (formerly the Golden West Walk to Defeat ALS)?

Please complete this pre-registration form and we will notify you once we are ready to assist you with your registration. Our sites will be live soon!

1. Field Is Required Which Walk & Roll to Cure ALS event(s) would you like to attend?** (Select one or more)

Sunday, August 18, 2024 - Big Island Walk & Roll to Cure ALS
Sunday, September 8, 2024 - Central Valley Burnout, Walk, & Roll to Cure ALS
Saturday, October 5, 2024 - Silicon Valley Walk & Roll to Cure ALS
Saturday, October 19, 2024 - Monterey Bay Walk & Roll to Cure ALS
Late October 2024 - Inland Empire Walk & Roll to Cure ALS
Saturday, October 26, 2024 - Kern County Walk & Roll to Cure ALS
Saturday, November 2, 2024 - East Bay Walk & Roll to Cure ALS
Saturday, November 9, 2024 - Hawaii Walk & Roll to Cure ALS
Early December 2024 - LA Walk & Roll to Cure ALS

2. Please enter your personal Information:

Title

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Middle

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Field Is Required Date of Birth:

Field Is Required Gender:

Employment Information

Employer:

Street 1:

Street 2:

City/Town:

State / Province:

ZIP / Postal Code:

Country:

Field Is Required Email:

Field Is Required Phone Number:

If you respond and have not already registered, you will receive periodic updates and communications from ALS Network.

Yes, I would like to receive postal mail from ALS Network.

3. Field Is Required My preferred contact method is:

4. Field Is Required Is it OK for us to text you?

5. Field Is Required What is your ALS connection?

6. If you have more information about your ALS connection that you want to share, please add it here.

7. If you have participated in the past, for how many years have you been a part of the event?

8. Are you walking or rolling in honor or in memory of someone?

9. If you are participating in honor or in memory of someone, please list their name(s): (Maximum response 255 chars, approx. 5 rows of text)

10. Field Is Required Select your participation type:

11. What is your fundraising goal? (you can adjust your goal at any time)

12. Field Is Required Participants who raise $100 or more earn a commemorative Walk & Roll to Cure ALS t-shirt. What size are you?

13. Field Is Required Preferred username for login (subject to availability; email addresses accepted):

14. Did someone invite you to sign up? If so, please list their name: (Maximum response 255 chars, approx. 5 rows of text)

Spam Control Text: Please leave this field empty