Walkathon Registration

(ALL EVENT ACTIVITIES AND REFRESHMENTS INCLUDED)

Saturday, November 5, 2011

Register early! Regular price increases to $20 after October 30.

A limited quantity of T-shirts are available - secure your shirt now.

* All online transactions will be handled through PayPal.

Regular Registration - $20*

Includes a free event T-shirt!

Group, church, or company you are associated with:
T-Shirt Size

Senior Registration (65 and up) - Free

Includes a free event T-shirt!

Group, church, or company you are associated with
T-Shirt Size

Resident Registration

Residents of a retirement community, assisted living facility, or nursing home qualify for free registration. Send an email with the following information to alex@asianmedicalclinic.org to register. We will verify the information and send you a confirmation email.

  1. Your full name
  2. Name of your nursing or retirement home
  3. Address of nursing/retirement home

Information is used to verify residency. Your information is confidential; our records are deleted immediately after confirmation.

If your would like to walk in the event, please make sure that you are physically able to do so.

Want a T-Shirt?

If you just want to purchase a Walkathon T-Shirt, they are available for just $10!*

(pick up directly from us to avoid shipping cost)

Please specify method of pickup:

A) Pick up on event day at the Walkathon table (between 9:00 AM and 1:00 PM)

B) Pick up at the Asian Medical Clinic after Walkathon during clinic open hours (46356 Warm Springs Blvd. #872 Fremont, CA 94539).

Method of Pickup
T-Shirt Size

Registration by Mail

If online payment isn't a option, you can mail the registration form to us.

Download Form Here

Please download the Registration form, fill out the information, and mail the form to:

Kimberli Cheung
Asian Medical Clinic
46356 Warm Springs Blvd. #872
Fremont, CA 94539

Please be sure to include a phone number & email address so that we can notify you when we've received the form.

Registration by Phone

To register by phone, call Asian Medical Clinic at (510) 770-1300
(Ask to speak to Angela or Alexandra about Walkathon.)

Please have your payment information ready.