A Butterfly's Touch presents their 1st annual
Walk to Remember
“Honoring Little Lives Lost”

Join us in honoring the memory of the nearly 875,000 babies who die each year
through miscarriage, stillbirth, or newborn death.

9:00 am ~ 12:00 noon
Saturday, October 16th, 2010

Valley View Church
11501 SE Sunnyside Road, Clackamas, OR

Free to Participate — Families Welcome!

Participate in the one-mile Walk to Remember,
make a scrapbook page for our memorial album,
visit with others during the dessert reception,
and help us honor the little lives lost at our memorial ceremony.

Pre-registration is encouraged, and required if you want to reserve a shirt or sweatshirt in your size.
You may fill out and submit the following form, or, if you prefer to print and mail it or pay with a check, you may use this form.

If you cannot attend but would like to support the event by making a donation,
please see our How to Help page.

I'm walking as:	An Individual A Family
My Contact Information:
First Name:
Last Name:
Email Address:
Phone:
Address Line 1:
Address Line 2:
City:
State:
ZIP:
Other walkers in my family:
T-Shirt Pre-orders:
Please indicate the number and sizes of shirts and/or sweatshirts you will need. Shirts are $10 if pre-ordered, and $15 at the event. Sweatshirts are $25 if pre-ordered, and $30 at the event. If you pre-order shirts with the form below, we will send an invoice to the email you provided above, so make sure it's correct!
Youth Shirts:	S(6-8) M(10-12) L(14-16)
Adult Shirts:	S M L XL XXL
Youth Sweatshirts:	S(6-8) M(10-12) L(14-16)
Adult Sweatshirts:	S M L XL XXL
Waiver:
By completing this form and clicking the "Register" button below, I/we hereby waive all claims against and hold harmless Walk to Remember and A Butterfly's Touch, their sponsors, volunteers, and/or staff for any injury I may suffer at the Walk event. I/we give full permission for A Butterfly's Touch to use any photographs, video or other recording of me for legitimate purposes and promotion of the event.