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April 20, 2019 Family Fun Walk Registration

Please complete to register for the 2019 Family Walk benefiting Humane Tomorrow. The 1-mile walk starts at 8 am.  If participant is under 18 years of age, participant's guardian must submit the registration form.  Since the walk is free, it does not include a t-shirt.  Also, the 1-mile walk is not timed, and no medals are awarded for it. 

WAIVER:

I, the person submitting this entry, am aware that participating in an event such as a race or walk is a potentially hazardous activity, and that I (or this minor, if I am signing as parent/guardian) should not so participate unless physically able. I verify that I (or this minor) am medically fit to participate and will have sufficiently trained for the event prior to participation. I (and this minor, if I am signing as parent or guardian) agree to abide by the rules and decisions of any event officials, relating to participation, and assume all risks associated with participation in the event and any associated event or activities, including but not limited to, falls, contact with other participants, effects of the weather, traffic and road conditions. By my submitting this form, I assume full and complete responsibility for any injury or accident which may occur to me during the event or while I am on the premises of the event, and I hereby release and hold harmless the presenters and all other person and entities associated with the event from liability for injuries and damage sustained by me. Further, I grant permission to use any photographs, videotapes, or any other records of this event involving me for any legitimate purpose.

IF PARTICIPANT IS UNDER AGE 18: I certify that as guardian this minor has my permission to compete in the Wellington Family Fun event, is in good physical condition, and that officials have my permission to authorize emergency treatment if necessary. I also agree that any participant under the age of 12 will be accompanied by an adult 18 years or older.

2019 Walk Registration

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Last Name:
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First Name:
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Age of participant:
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Address:
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City:
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State:
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Zip:
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Phone number:
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Email address:
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I acknowledge and accept the waiver statement above
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If participant is under 18 years of age I acknowledge I am their guardian
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Signature/Guardian
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Completed form will be sent to: fitness@wellingtonhoa.net
This form will be stored and encrypted and can be retrieved
Connected to: Walk Form.pdf
Last Modified: 2/12/2019 10:51:30 AM
Form ID: 7d1fcf8f-772c-4284-8286-324bf289383d

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