Ability Walk Team Sign Up Sheet
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1ABILITY WALK TEAM SIGN UP SHEET
(Duplicate Form as needed)
Team Captain:
Team Name:
Home Phone:
E-mail:
Instructions:
This form can be used as the registration form for team members. All participants must sign that they have read and agree to the waiver statement.
If the participant is under the age of 18, the parent or guardian’s signature is required. Please turn this form in when registering the day of the event.
First Name
Last Name
Address (City, State, Zip)
E-mail
Signature of Waiver
Amount Collected
TOTAL RAISED:
WAIVER OF LIABILITY: In consideration of me and/or my minor child being permitted to participate in the Ability Walk, I hereby – for myself, my heirs, and personal
representatives – assume any and all risks that might be associated with the event. I further waive, release, discharge and covenant not to sue the Walla Walla
Valley Disability Network (WWVDN), its officers, employees, sponsors, organizers, volunteers, or other representatives or their successors and assigns, for any and all
injuries or damages of any kind whatsoever suffered by myself and/or my minor child as a result of taking part in the events and any related activities. I also authorize
the use by WWVDN of any photo, film, or videotape taken of me and/or my minor child at the event for any purpose. PLEASE SIGN ABOVE.
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