Walk & Roll to School Day Registration

Contact Name *

Title

School Name *

Street Address *

(materials are shipped via UPS; please no P.O. boxes)

City *

County *

State *

Zip Code *

Email *

Phone Number *

How Many Students Will Be Involved? *

This is the number we use to determine the amount of materials to send to your school

Grades

Example: K-2, K-5, K-6, 6-8, etc.

In addition to Walk & Roll to School Day *

Please register me for the next Bike & Roll to School Day

Please send me more information on Safe Routes to School

I would like to receive the following materials in the mail

W2SD planning materials and stickers

Photo Permission

I hereby grant the Michigan Fitness Foundation the right to use and publish photographs of all those participating in our Bike to School Day, and/or Walk to School Day event(s).

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