Footprints Forever on Our Hearts
2nd Annual Memorial Walk

Registration and Waiver

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Registration Information
Name of Participant:
Mailing Address:
Gender:
Email Address:
Phone Number:
I'm walking in memory of:
I will be collecting pledges:
 
Release Form: All Participants must read and accept this agreement.

In consideration of the acceptance of this entry, I, hereby, for myself and my heirs, executors and administrators, waive any and all rights, claims and damages I have against the sponsors, coordination groups, and volunteers.

Also, none of the above are responsible for the loss of personal items nor any other form of aggravation in connection with said event. I have been warned I must be in good health to participate in the event.

In filling out this form, I acknowledge that I am an amateur in such event. I also give permission for the free use of my name and picture in any broadcast, telecast, electronic or print media account of this event.

This event will occur rain or shine. In the event of extreme circumstances we reserve the right to cancel. Rather than a refund, your registration will be donated to The Elisa Gastellum Memorial Foundation/Footprints Forever On Our Hearts Support Group, or the memorial fund of your choosing.

Name of Participant / Legal Guardian: Date of Agreement:
By entering your name and submitting this form you agree to be bound by the terms of this release. Your typed name and submission of this form shall be considered legally binding, with the effect of a signature.

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Download PDF Pledge Form
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