Long Walk To Freedom - Registration
Please use this form to Register Online. Donations are accepted by PayPal.
Firstname/Lastname  
Boaz and Ruth, Inc.
3030 Meadowbridge Road
P. O. Box 6129
Richmond, Virginia 23222
804 329-4900
info@boazandruth.com
Address
City, State  Zip
Phone
Email
Your Group
How did you hear
about The Walk?
Supporting:
(select one)
Assisting Families of Inmates
Boaz & Ruth
Bridging The Gap In Virginia
Drive to Work
Fifth Street Baptist Church
Jordan's Quest, Inc.
NAMI-CVA, National Association on Mental Illness - Central V
OAR, Inc. Richmond
Probation & Parole for District 1
RIHD, Resource Information Help for Disadvantage
Saving Our Youth
St. Paul's Baptist Church
I will be:
Participating in the Walk
Not walking, but please accept my donation!
Donation Amount $ $15 minimum. Please give generously! - PayPal
Payment Method PayPal  Check 
View Waiver I am in agreement with terms of the Waiver - read waiver
Would you like to volunteer to work with the walk?  Yes No
Research Information (optional):
Have you ever been incarcerated? Yes No  -- If so, how long? 
Do you know anyone who has been incarcerated? Yes No -- Family Friend