CODY Center Walk for Autism & Developmental Disabilities

Cody Center Walk

Welcome to the Cody Center Walk Sign Up Page. Please select what you would like to do.

If you wish to register as an Individual walker, click the Walk as an Individual button.
If you wish to register AND join a Team, click the Join a Team button.
If you wish to register AND create a Team, click the Create a Team button.

Walk as an Individual Join a Team Create a Team

Items in bold are required.

Team Information

Name of Team:

Team Fundraising Goal:	$ (whole dollar amounts ONLY)

Registration Information

First Name:

Last Name:

Company Name:

Street Address 1:

Street Address 2:

Street Address 3:

City:

State:

Zip:

Daytime Phone Number:

(xxx-xxx-xxxx)

E-mail Address:

May we display your name on our website? Yes No

Would you like to have your email address made available to others? Yes No

Would you like to receive periodic e-mails from the Cody Center? Yes No

Would you like to be e-mailed when a gift is made on your behalf? Yes No

There is a registration fee of $20 for Adults. There is no fee for Students or Children. If you wish to make an additional donation, please enter the new amount in the field below.

Are you a Student/Child? Yes

Number of Adult Walkers Number of Student/Child Walkers

Amount:

$ (whole dollar amounts ONLY)

Additional Information

Who in your life is affected by a developmental disability?

When you click the Submit button, you will leave the Cody Walk site and be transferred to a secure Stony Brook website where you will complete the donation process. Please note that the web page you are first brought to DOES NOT require any information to be input. Just click the Proceed to next screen button. At the completion of your transaction, you will be returned to the Cody Center website. Thank You for your support.