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 Name2024 Capital Region Heart Walk
Event ID10729
Participant ID28640894
Participant NameNychelle Jackson
Team NamePSECU
Team ID
Mailing Information
Please send this completed form with checks to:American Heart Association | Attn: Capital Region Heart Walk | 4250 Crums Mill Rd, Ste 100 | Harrisburg, PA 17112