www.rileywalkathon.com
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Submitted URL: https://rileywalkathon.com/
Effective URL: https://www.rileywalkathon.com/
Submission: On July 24 via api from US — Scanned from DE
Effective URL: https://www.rileywalkathon.com/
Submission: On July 24 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
POST index.php#register
<form id="registration_form" action="index.php#register" method="post" class="contact_form">
<fieldset>
<div id="participants">
<div class="participant">
<div class="register-input-float-area">
<label for="participant[0][first_name]">
<h2 class="blue">First Name <span class="required">*</span></h2>
</label>
<input name="participant[0][first_name]" value="" maxlength="128" type="text"><br>
</div><!--register-input-float-area-->
<div class="register-input-float-area">
<label for="participant[0][last_name]">
<h2 class="blue">Last Name <span class="required">*</span></h2>
</label>
<input name="participant[0][last_name]" value="" maxlength="128" type="text"><br>
</div><!--register-input-float-area-->
<div class="register-tshirt-area">
<label for="participant[0][tshirt_size]">
<h2 class="blue">T-Shirt Size <span class="required">*</span></h2>
</label>
<select name="participant[0][tshirt_size]" type="text">
<option value="None Chosen">Select a size</option>
<option value="None">None</option>
<option value="Youth S">Youth S</option>
<option value="Youth M">Youth M</option>
<option value="Youth L">Youth L</option>
<option value="Adult S">Adult S</option>
<option value="Adult M">Adult M</option>
<option value="Adult L">Adult L</option>
<option value="Adult XL">Adult XL</option>
<option value="Adult 2XL">Adult XXL</option>
</select>
</div><!--register-t-shirt-area-->
<input name="participant[0][complete]" class="complete" type="hidden" value="">
<div class="clear"></div>
</div><!--participant"-->
<div class="participant">
<div class="register-input-float-area">
<label for="participant[1][first_name]">
<h2 class="blue">First Name</h2>
</label>
<input name="participant[1][first_name]" value="" maxlength="128" type="text"><br>
</div><!--register-input-float-area-->
<div class="register-input-float-area">
<label for="participant[1][last_name]">
<h2 class="blue">Last Name</h2>
</label>
<input name="participant[1][last_name]" value="" maxlength="128" type="text"><br>
</div><!--register-input-float-area-->
<div class="register-tshirt-area">
<label for="participant[1][tshirt_size]">
<h2 class="blue">T-Shirt Size</h2>
</label>
<select name="participant[1][tshirt_size]" type="text">
<option value="None Chosen">Select a size</option>
<option value="None">None</option>
<option value="Youth S">Youth S</option>
<option value="Youth M">Youth M</option>
<option value="Youth L">Youth L</option>
<option value="Adult S">Adult S</option>
<option value="Adult M">Adult M</option>
<option value="Adult L">Adult L</option>
<option value="Adult XL">Adult XL</option>
<option value="Adult 2XL">Adult XXL</option>
</select>
</div><!--register-t-shirt-area-->
<input name="participant[1][complete]" class="complete" type="hidden" value="">
<div class="clear"></div>
</div><!--participant"-->
</div>
<div class="additional-participants">
<a id="add_participant" href="#" onclick="return false;">+ Add additional participants</a>
</div><!--additional-participants-->
<div class="register-input-float-area">
<label for="email">
<h2 class="blue">Email Address <span class="required">*</span></h2>
</label>
<input id="email" name="email" value="" maxlength="256" type="text">
</div><!--register-input-float-area-->
<div class="register-input-area">
<label for="donate_more">
<h2 class="blue">Do you want to donate an additional amount?</h2>
</label>
<input id="donate_more" name="donate_more" value="" type="text">
</div><!--register-input-float-area-->
<div class="register-input-area">
<h2 class="blue">Do you want a T-Shirt?</h2>
<div class="register-radio-area">
<label id="tshirt_yes"><span>Yes</span> <input name="tshirt_required" value="Yes" type="radio"></label>
</div><!--register-radio-area-->
<div class="register-radio-area">
<label id="tshirt_no"><span>No</span> <input name="tshirt_required" value="No" type="radio"></label>
</div><!--register-radio-area-->
<div class="register-input-area">
<h2 class="blue">Are you a Deaconess employee? <span class="required">*</span></h2>
<div class="register-radio-area">
<label id="deaconess_participant_yes"><span>Yes</span> <input name="deaconess_participant" value="Yes" type="radio"></label>
</div><!--register-radio-area-->
<div class="register-radio-area">
<label id="deaconess_participant_no"><span>No</span> <input name="deaconess_participant" value="No" type="radio"></label>
</div><!--register-radio-area-->
</div><!--register-input-float-area-large-->
<div id="deaconess_department_physician_container">
<div class="register-input-area">
<label for="deaconess_department_physician">
<h2 class="blue">What is your department/physician's name?</h2>
</label>
<input id="deaconess_department_physician" name="deaconess_department_physician" value="" maxlength="128" type="text">
</div><!--register-input-area-->
</div><!--deaconess_department_physician-->
<script type="text/javascript">
$("#deaconess_participant_yes").click(function() {
$("#deaconess_department_physician_container").slideDown("slow");
});
</script>
<div class="register-input-area">
<h2 class="blue">Are you a Riley family? <span class="required">*</span></h2>
<div class="register-radio-area">
<label id="riley_participant_yes"><span>Yes</span> <input name="riley_participant" value="Yes" type="radio"></label>
</div><!--register-radio-area-->
<div class="register-radio-area">
<label id="riley_participant_no"><span>No</span> <input name="riley_participant" value="No" type="radio"></label>
</div><!--register-radio-area-->
</div><!--register-input-float-area-large-->
<div id="riley_family_container">
<div class="register-input-area">
<label for="riley_family_name">
<h2 class="blue">What is the family name?</h2>
</label>
<input id="riley_family_name" name="riley_family_name" value="" maxlength="128" type="text">
</div><!--register-input-area-->
</div><!--riley_family_name-->
<script type="text/javascript">
$("#riley_participant_yes").click(function() {
$("#riley_family_container").slideDown("slow");
});
</script>
<div class="register-input-area">
<label for="kiwanis_organization">
<h2 class="blue">Are you a member of a Kiwanis Club?</h2>
</label>
<select name="kiwanis_organization" type="text">
<option value="None Chosen">Select an organization</option>
<option value="Castle">Castle</option>
<option value="Central">Central</option>
<option value="Day School">Day School</option>
<!-- <option value="Downtown">Downtown</option> -->
<option value="Evansville">Evansville</option>
<option value="Evansville Christian School">Evansville Christian School</option>
<option value="Green River">Green River</option>
<option value="Harrison">Harrison</option>
<option value="Historic Newburgh">Historic Newburgh</option>
<option value="Ivy Tech">Ivy Tech</option>
<option value="Memorial">Memorial</option>
<option value="Mount Vernon">Mount Vernon</option>
<option value="New Harmony">New Harmony</option>
<option value="Newburgh">Newburgh</option>
<option value="North">North</option>
<!-- <option value="Northside">Northside</option> -->
<option value="Poseyville">Poseyville</option>
<option value="Reitz">Reitz</option>
<option value="Signature">Signature</option>
<option value="UE">UE</option>
<!-- <option value="Westside">Westside</option> -->
</select>
</div><!--register-input-area-->
<div class="register-input-area">
<label for="payment_method">
<h2 class="blue">Payment Method ($25 per participant) <span class="required">*</span></h2>
</label>
<select name="payment_method" type="text">
<option value="None Chosen">Select a method of payment</option>
<option value="PayPal">PayPal (will redirect on submit)</option>
<option value="Cash/Check">Check (sent to address below)</option>
</select>
</div><!--register-input-area-->
</div>
</fieldset>
<div class="register-notice">
<p>If you are paying via Paypal, you will be redirected to the Paypal payment page after you click the submit button.<br>If you are paying via check, please mail it to:<br><br>Kiwanis Riley Walk<br>Sharon Johnson<br>3800 Herndon
Dr.<br>Evansville, IN 47715</p>
</div><!--register-notice-->
<div class="register-required-message">
<span class="register-required">* Required fields</span>
</div><!--register-required-message-->
<div class="button-holder">
<button id="registration_submit" class="button" name="registration_submit" value="Submit" type="submit">Submit</button>
</div><!--button-holder-->
</form>POST index.php#contact
<form action="index.php#contact" method="post" class="contact_form">
<fieldset>
<div class="contact-input-float-left-area">
<label for="first_name">
<h2 class="blue">First Name <span class="required">*</span></h2>
</label>
<input id="first_name" name="first_name" value="" maxlength="128" type="text">
</div><!--contact-input-float-left-area"-->
<div class="contact-input-float-area">
<label for="last_name">
<h2 class="blue">Last Name <span class="required">*</span></h2>
</label>
<input id="last_name" name="last_name" value="" maxlength="128" type="text">
</div><!--contact-input-float-area"-->
<div class="contact-input-area">
<label for="email">
<h2 class="blue">Email Address <span class="required">*</span></h2>
</label>
<input id="email" name="email" value="" maxlength="256" type="text">
</div><!--contact-input-area-->
<div class="contact-input-area">
<label for="comments">
<h2 class="blue">Message <span class="required">*</span></h2>
</label>
<textarea id="comments" name="comments" rows="6"></textarea>
</div><!--contact-input-area-->
</fieldset>
<div class="contact-required-message">
<span class="required">* Required fields</span>
</div><!--contact-required-message-->
<div class="button-holder">
<button class="button" name="submit" value="Submit" type="submit">Submit</button>
</div><!--button-holder-->
</form>Text Content
* Home * Register * Sponsors * Photos * Contact THE 32ND ANNUAL RILEY WALK PRESENTED BY THE KIWANIS CLUBS OF SOUTHWESTERN INDIANA, IN PARTNERSHIP WITH DEACONESS RILEY CHILDREN'S SERVICES. ON-LINE REGISTRATION IS CLOSED. WALK-INS MAY REGISTER AT 9:00 AM SATURDAY MORNING, FEBRUARY 24, 2024 AT EASTLAND MALL. Reg Closed SATURDAY, FEBRUARY 24, 2024 In recent years, the Kiwanis Clubs of the Southwind Division have raised more funds for Riley Children's Hospital than any other Kiwanis Division in the State of Indiana, totaling over $606,000. This is thanks in part to the great dedication of the Evansville community, parents and individuals impacted by Deaconess Riley Children's Services and Riley Children's Hospital. We thank you for your consideration and support. » FLYER PDF (TO DOWNLOAD, RIGHT CLICK AND SELECT "SAVE AS...") REGISTER TODAY! Help support the Kiwanis Clubs of the Southwind Division raise money for Deaconess Riley Children's Services and Riley Children's Hospital by signing up today to donate to the 32nd Annual Riley Walk. Registration is $25 per participant. Please note that pre-registration closes Thursday, February 22nd at 5:00PM. After this time, you will need to register at the event. FIRST NAME * LAST NAME * T-SHIRT SIZE * Select a size None Youth S Youth M Youth L Adult S Adult M Adult L Adult XL Adult XXL FIRST NAME LAST NAME T-SHIRT SIZE Select a size None Youth S Youth M Youth L Adult S Adult M Adult L Adult XL Adult XXL + Add additional participants EMAIL ADDRESS * DO YOU WANT TO DONATE AN ADDITIONAL AMOUNT? DO YOU WANT A T-SHIRT? Yes No ARE YOU A DEACONESS EMPLOYEE? * Yes No WHAT IS YOUR DEPARTMENT/PHYSICIAN'S NAME? ARE YOU A RILEY FAMILY? * Yes No WHAT IS THE FAMILY NAME? ARE YOU A MEMBER OF A KIWANIS CLUB? Select an organization Castle Central Day School Evansville Evansville Christian School Green River Harrison Historic Newburgh Ivy Tech Memorial Mount Vernon New Harmony Newburgh North Poseyville Reitz Signature UE PAYMENT METHOD ($25 PER PARTICIPANT) * Select a method of payment PayPal (will redirect on submit) Check (sent to address below) If you are paying via Paypal, you will be redirected to the Paypal payment page after you click the submit button. If you are paying via check, please mail it to: Kiwanis Riley Walk Sharon Johnson 3800 Herndon Dr. Evansville, IN 47715 * Required fields Submit 2024 Sponsors PHOTO GALLERY Play Slideshow ‹ Previous PhotoNext Photo › * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 1234…9Next › CONTACT US We invite you to use the form below to send us any questions or comments. CHECKS MAY BE MAILED TO: Kiwanis Riley Walk Sharon Johnson 3800 Herndon Dr. Evansville, IN 47715 Please make checks payable to Kiwanis Riley Walk. FIRST NAME * LAST NAME * EMAIL ADDRESS * MESSAGE * * Required fields Submit Copyright © 2024 Kiwanis Clubs of the Southwind Division. All rights reserved. Web site design & development by Kemper Technology Consulting.