Breast Cancer Awareness Walk: Honor a Survivor or Remember a Loved One

Who Are You Walking For?

2026 Breast Cancer Awareness Walk Recognition Form

Can’t join us this Saturday? You can still share your name or the name of a loved one you would like us to walk for. We will honor breast cancer survivors, support those currently facing breast cancer, and remember loved ones who have passed away. Those attending are also welcome to submit a name.

Join Mayor Helmin J. Caba and the Raritan Bay Area YMCA on Saturday, November 7, 2026, at Thomas Mundy Peterson Park, 40 Washington Street, Perth Amboy, NJ.

9 a.m.: Registration and check-in
10 a.m.: Walk begins

Because awareness doesn’t end in October.

With your permission, we will read the submitted name aloud before the walk. Please submit one form per person you would like recognized. You may submit more than one form.

Please submit by noon on Friday, November 6, 2026, to be included in the recognition before Saturday’s walk.

This form is for name recognition only. It does not register you to participate in the walk or reserve a shirt.

Fields marked with an asterisk (*) are required. Please do not include medical or treatment details.

Your name *

Your email address *

For questions about your submission. Your contact information will not be included in the public recognition.

Phone number (optional)

Name of the person you would like recognized *

You may submit your own name or a loved one’s name. Enter it exactly as you would like it read. A first name only is welcome.

This recognition is: *

How is their name pronounced? (optional)

Your relationship to this person (optional)

Brief message or dedication (optional)

Please limit your message to 25 words. Messages may be read as time allows, with your permission below.

May we read this person’s name aloud before the walk? *

You may also read my dedication aloud, if I selected public recognition above.

Authorization *
I am submitting my own name or have permission to submit this person’s name. If I am recognizing another person who is living, I have their consent for the public recognition selected above, including any dedication I have authorized to be read.

For questions or help submitting a name, contact the Mayor’s Office at (732) 826-0290 ext. 4002.

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