Team Registration:

Walking to Remember brings families, friends, and communities together to honor loved ones and support dementia caregivers across Alabama. Register today, take a meaningful step toward making a difference, and thank you for being part of this mission.

Use the form below to register your team. Here are a few tips:

• Let your team know the goal you have set – Once they are aware of how much you hope to raise, they will be motivated to help you reach that goal.
• Encourage them to visit our website to learn more about our programs for help families struggling to care for a loved one at home.
• Remind them of the Walk t-shirts! Receive a short-sleeved shirt with your $50 donation or a long- sleeved shirt for a $75 donation.

Walk Team Registration 2026

Team Pledge ($) - This will be displayed on the Walk Team Progress page.

Team Name - Displayed on the Walk Team Progress page. *

Team Leader *

Address (line one)

Address (line two)

City

State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code

Phone Number

Email Address

Do you have a 2nd Team Leader?

Yes

No

Team Co-Leader Name

How many Leader T-shirt(s) do you need?

1

2

3

Team Leader T-shirt Size (Shirts will be given out at Kickoff Rally or on the day of the walk) SmallMediumLargeX-LargeXX-LargeXXX-Large

Team Leader T-shirt Size (Shirts will be given out at Kickoff Rally or on the day of the walk) SmallMediumLargeX-LargeXX-Large

Team Leader T-shirt Size (Shirts will be given out at Kickoff Rally or on the day of the walk) SmallMediumLargeX-LargeXX-Large

What inspired your team to participate in Walking to Remember?

If this is your first Walking to Remember, where did you hear about ACA?

Family/friends

Web/social media

Church/community group

Caregiver referral

Healthcare provider

Would you like to receive our weekly resource e-newsletter?

Yes

No

I'm already subscribed

Optional Comments (any instructions you would like to include)

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