Please display my name on the participant's public donor wall as:
Please do not display my name on the donor wall.
Participant Information
Event Name2025 Capital Region Heart Walk & Run
Event ID11394
Participant ID
Participant Name
Team Name
Team ID
Mailing Information
Please send this completed form with checks to:American Heart Association | Attn: Capital Region Walk/Run | Four Gateway Center444 Liberty Ave, Ste 1300 | Pittsburgh, PA 15222