Register For Moving Day - Moving Day

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Start A Team

Team Name*
Team Type*
Select below to associate your team with a company
- Is this a company team?
Team Fundraising Goal
Create A New Company
Select Company
Would you like to associate your participation with a company?
- Would you like to associate your participation with a company?

Join A Team

Select Team*

Recreate A Team

Select Team to Recreate*
Team Fundraising Goal

Participation & Fundraising

Participation Type
- I'm going to walk on Moving Day
- I'm participating in the 5k
Individual Fundraising Goal
Registered walkers who raise $100 before event day qualify for the official Walk t-shirt (pick up onsite only). Plus, raise $250 or more and qualify for day of incentive prizes.
Your t-shirt size*
Email Donations In My Name
- I would like to be emailed when a gift is made on my behalf
Kick-start your fundraising with a donation!
- $35
- $100
- $250
- $500
- I'll donate/fundraise later
Anonymous Gift
- Please make this an anonymous gift
Display on Donor Wall
- Yes, display the amount of my donation on the public donor wall

Registration & Contact

Are You Registering Yourself or Someone Else?

I'm registering myself
I'm registering someone else

When registering on behalf of someone else:
- Email address becomes their username
- They will set their own password
Title*
First Name*
Last Name*
Email Address*
Username*
Password*
Keep Me Logged In
- Keep Me Logged In

Address

Address
Street 1 Street 2 City State / Province ZIP / Postal Code Country
Phone

Other Information

How did you hear about Moving Day?*
If Other, Please Describe*
I am walking*
Name of person you are walking in honor or memory of
What best describes your connection to Parkinson's Disease (PD)?*
If Other, Please Describe
You selected healthcare professional, please specify
If Other, Please Describe
Are you involved with the person with Parkinson's care?*
Please share the year of Parkinson's diagnosis

Agree to Terms

Waiver: Moving Day® Walk involves walking and related activities, much of which occurs outside on public streets and sidewalks, requiring participants to navigate traffic, road conditions, other participants and other pedestrians and cyclists, as well as dealing with possible adverse weather conditions. This involves risks such as, but not limited to, falls, being struck by cars or other vehicles or bicycles, or colliding with other persons, any of which may result in property loss, personal injury, or even death. Participants are permitted to have their dogs accompany them in this event, which presents risks of being bitten, knocked down, or tripped, which also may cause bodily injury or death. In consideration of being allowed to participate in this event, I hereby expressly assume all such risks.

I am solely responsible for my own health and safety. I represent that I am healthy, physically fit, and medically able to participate in this event.

I hereby for myself, my family, my heirs, executors and administrators, release from liability, waive all claims against, hold harmless, and agree not to sue the Parkinson’s Foundation, its chapters, their respective officers, directors, volunteers, employees, sponsors and agents, individually and collectively, for any harm, damage, injury, or death arising out of my participation in this event and related activities EVEN IF RESULTING FROM THE NEGLIGENCE OF THE PARKINSON’S FOUNDATION OR OTHER ABOVE PERSONS.

I grant full permission to the organizers of this event to photograph and videotape me in connection with the event and to use my image and name in any and all media, including for marketing and promotional purposes.

If any term of this Agreement is held illegal, unenforceable, or in conflict with law, the validity of the remaining portions shall not be affected thereby.

I have read, understand and agree to the terms of this agreement.

BY AGREEING YOU MAY BE GIVING UP IMPORTANT LEGAL RIGHTS. PLEASE READ AND BE CERTAIN YOU UNDERSTAND EVERYTHING BEFORE AGREEING.

If Participant is under the age of 18, the parent or guardian must agree to the below:
I am the legal guardian of Participant, and I hereby consent to his/her participation. I have read the foregoing agreement, and I hereby agree on behalf of myself and Participant to its terms.
By registering you are automatically signed up to receive Moving Day email updates
Agree With Terms and Conditions*
- I agree to the terms & conditions

Submit Payment

Credit Card Information*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Credit Card Number Expiration Date CVV Number What is this? Name on Credit Card
Billing Info Same
- Billing address same as contact information
Billing Information*
Prefix First Last Suffix
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

First Name

{First Name:15}

Last Name

{Last Name:16}

Email Address

{Email Address:19}

Username

{Username:17}

Password

{Password:56}

Address

{Address (Street Address):125.1} {Address (Address Line 2):125.2}
{Address (City):125.3}, {Address (State / Province):125.4} {Address (ZIP / Postal Code):125.5}
{Address (Country):125.6}

Billing Information

{Billing Information (First):63.3} {Billing Information (Last):63.6}

Billing Address

{Billing Address (Street Address):64.1} {Billing Address (Address Line 2):64.2}
{Billing Address (City):64.3}, {Billing Address (State / Province):64.4} {Billing Address (ZIP / Postal Code):64.5}
{Billing Address (Country):64.6}

Registration Type

{Registration Type:74}

Update Registration

{Update Registration:105}

Select Team

{Select Team:59}

Team Name

{Team Name:77}

Select Team to Recreate

{Select Team to Recreate:83}

Moving Day National Partner

BlueRock Logo Full Color Final

Moving Day National Teams

Edward-Jones-logo

Toll-free Helpline: 1-800-4PD-INFO (473-4636)

Miami: 5757 Waterford District Drive, Suite 310, Miami, FL 33126
NY: 1359 Broadway, Suite 1509, New York, NY 10018

movingday@parkinson.org

The Parkinson’s Foundation is a 501(c)(3) nonprofit organization.
EIN: 13-1866796

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