Community Hike Starter Form

Thank you for your interest in hosting a Skin Cancer, Take a Hike! community hike. Hosting a community hike is a great way to raise money and bring awareness to skin cancer and melanoma within your local community. Once you complete the form below, we will provide guidance on how to make your hike successful.

1. Contact: Please provide contact information for the person organizing this event.

If you have previously registered, please to prepopulate your information.

*

*

 

*

*

 

 

 

 

 

*

 

If you respond and have not already registered, you will receive periodic updates and communications from American Academy of Dermatology.

Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

*

5 to 60 characters

*

5 to 20 characters

*

 


*2.
Question - Required - Why are you interested in hosting a Skin Cancer, Take a Hike! community hike? (check all that apply)

3.

*4.  


*5.  


6.
Question - Not Required - Proposed event date:




*7.

(Maximum response 255 chars, approx. 5 rows of text)

8.

(Maximum response 255 chars, approx. 5 rows of text)

*9.


   Please leave this field empty