Individual Registration 2014
Individual's Name: _____________________________________________________________________________________________
Company Name (if applicable): ______________________________________________________________________________________
Street Address: __________________________________________________________________________________________________
City: ______________________________ State: _________ ZIP: _____________________
PHONE: (
) _________________
Email Address: ___________________________________________________________________________________________________
Waiver: In consideration of my entry into the Young Women's Christian Association (YWCA) Metro St. Louis Walk a Mile in Her Shoes event
- Thursday, June 5, 2014 - I agree to waive and release any and all rights and claims for injury, damages, or actions whatsoever in any manner
I have or may have hereafter against the organizers of this event, its participants, its employees, all sponsors, and their respective employees
or representatives, as a result of my participation in this event - including travel to and from the event. I attest and verify that I am physically fit
and have sufficiently trained for participation in this event, and I have not been advised otherwise by any qualified medical personnel. Further, I
hereby grant full permission to any all and all of the foregoing to use my name, likeness, and image in any public broadcast, telecast, video,
print, or social media of this event and without compensation.
Signature: _____________________________________________________________________________________________
Sign Me Up!
 $25
The Marching Man
My Shoe Size (whole sizes only) : ____
T-Shirt Size (circle one): Sm Med
Lrg XL XXL
Includes event admission, an official Walk a Mile t-shirt, and custom-made men's heels. Men's official red shoe availability is on a first come, first served basis.
 $50
The Walking Man T-Shirt Size (circle one):
Sm
Med
Lrg XL XXL
Includes event admission, an official Walk a Mile t-shirt, and the option for man to wear his own shoes - they can still be heels. We won't judge.
 $25
The Rally Woman
T-Shirt Size (circle one): Sm Med
Lrg XL XXL
Includes event admission, an official Walk a Mile t-shirt, and cheering 'gear'. Rah! Rah!
I/We Can't Participate, but accept my/our gift to help end sexual and gender violence!
 $500
 $250
 $100
 $75
 $50
 $25
 $______ Other
Here's the Payment Information:
 My/our check is enclosed and payable to the YWCA Metro St. Louis in the amount of $ ___________
 Please charge my/our (circle one): VISA
MasterCard
Discover Card
Acct #: _______________________________________________________________________ Exp Date: _____ / ______
CVV: ____________
Name on Card: ____________________________________________________________________
Signature: ___________________________________________________________________________________________
The International Men’s March
to Stop Rape, Sexual Assault, and Gender Violence
Thursday, June 5, 2014 — Missouri Athletic Club
Please return registration form & payment to: YWCA Metro St. Louis ATTN: Lydia Huston
3820 West Pine Mall Blvd  St. Louis, MO 63108  [email protected]  FAX 314-531-5008
About Walk a Mile In Her Shoes 2014
The YWCA Metro St. Louis Walk A Mile in Her Shoes
event is now in its second year. This is a fun event to
raise awareness about a serious issue: sexual violence.
The YWCA Metro St. Louis's Women's Resource Center
has been the scene of countless heartbreaking
moments as counselors work with survivors of sexual
abuse and assault. Through the years, the YWCA has
seen - and served - thousands of victims as they face
their trauma and start the healing process.
But what if...we could stop rape and assaults before
they happen?
Engaging men in the conversation around sexual violence seems to be
the logical place to start. Men care about the safety and well-being of
their wives, daughters, sisters, and mothers; as well as their sons, brothers, fathers, and male friends who also can be victims of sexual assault
and abuse.
Why shouldn't men be as committed to this event as women? Why
can't men walk a mile in her shoes?
While the Walk a Mile in Her Shoes event has a serious purpose - be assured it will be a celebratory
event! Participants, clients, women, men, and friends of the YWCA Metro St. Louis will come together in a joyful affirmation of caring and determination to make a change by raising awareness.
We look forward to seeing you, your team captains, and your walkers this year!
You can find more information about the YWCA Metro St. Louis and its sexual assault counseling,
crisis intervention, assualt response services, and the Walk a Mile in Her Shoes 2014 event at the
YWCA Metro St. Louis website:
www.ywcastlouis.org
For more information, contact Lydia Huston at 314-531-1115 ext 230 or [email protected].
SPONSORED BY:
The International Men’s March
to Stop Rape, Sexual Assault, and Gender Violence
Thursday, June 5, 2014 — Missouri Athletic Club
Registration 5:00 p.m.  Walk 6:00 p.m.  Post-Walk Festivities 6:45 p.m.
FAQ: Frequently Asked Questions
There is an old saying:
You can’t really understand another person’s experience until you walk a mile in their shoes.
Q) What is Walk a Mile in Her Shoes®?
A) The International Men's March to Stop Rape, Sexual Assault & Gender Violence. A Walk a Mile in Her Shoes® event
is a playful opportunity for men to raise awareness in their community about the serious causes, effects, and remediation to sexualized violence and abuse of women - or men.
Q) Is Walk A Mile in Her Shoes® just about her?
A) Sexualized violence does not just affect women. It affects the men who care about them, their families, their friends,
their coworkers, and their communities. Sexualized violence is epidemic. Some statistics: Every two minutes someone in America is raped. One in six American women are victims of sexual assault. That means someone you know,
someone you care about, has been or may become the victim of sexual violence. It may be your mother, your sister,
your friend, your girlfriend, your wife, your coworker, or your daughter - or your son, brother, or best friend.
Q) So How Do We Walk the Walk?
A) Walk a Mile in Her Shoes® asks men to literally walk one mile in women's high-heeled shoes. It's not easy walking in
these shoes, but it's fun and it gets the community to talk about something that's really difficult to talk about: sexual
relations and sexual violence and abuse of women - or men.
Q) So How Do We Talk the Talk?
A) A Walk a Mile in Her Shoes® event is abundant with opportunities to get people talking. For preventive education, it
helps people better understand and appreciate victims' experiences, thus changing perspectives, helping improve
gender relationships and decreasing the potential for violence. For healing, it informs the community that services are
available for recovery. It demonstrates that men are willing and able to be courageous partners with women in making
the world a safer place - and vice versa.
Q) So How Can We Support the YWCA Metro St. Louis and Walk a Mile?
A) Encourage your company to become a sponsor. Grab nine (9) - or more! - of your best pals and register your team.
Host a (friendly) team-building and fund-raising competition at your company. Encourage men and women you know
to show up at the walk and cheer participants on. Make a personal donation to the YWCA Metro St. Louis. Ask your
friends to make a donation. See if your company will match your contribution(s). Spread the word!
For more information visit www.ywcastlouis.org or contact:
Lydia Huston, Assistant Director of Development, at 314-531-1115 ext 230 or [email protected]
SPONSORED BY:
The International Men’s March
to Stop Rape, Sexual Assault, and Gender Violence
Thursday, June 5, 2014 — Missouri Athletic Club
Registration 5:00 p.m.  Walk 6:00 p.m. Post-Walk Festivities 6:45 p.m.