First Name * Last Name * Email Address * Did you submit your form online? * Yes No Did you donate online via PayPal? Yes No How many hiking staffs do you need? * How many medallions do you need? * How many dog bandanas do you need? Are you currently receiving our monthly email newsletter? * Yes No Would you like to be added to our mailing list? * Yes No Photo and Video Waiver option * Often we take photos or videos at our events and programs to use in future publications. Use the yes or no buttons to let Portage Park District know if you agree to the photo and video consent. Photo and video consent: I agree to allow publication of any photo/media for future park district programming. Yes No Leave this field blank