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Registration / Donation Form

Thank you for your interest in the Buddy Walk!  Registration is $10 for adults and children over 5, and $7 for children under 5. 

Online donations are also being accepted! To make a tax-deductible donation to the Buddy Walk, please complete the following contact information then continue to the Donations section below. 

Mail-in registrations are no longer being accepted, but you can still donate by mail by downloading the attached brochure. Online registration will be available through August 20. Day of registration will be available beginning at 9:00am, but pre-registration is encouraged.

All registrations received after August 1 are not guaranteed a t-shirt.

Click Here To Download 2008 Buddy Walk Brochure
 
Contact Information
First Name:
Last Name:
Name of person you are participating for/sponsoring or your team name:
Address:
City:
   
State:
Zip:
Phone:
   
E-mail Address:
 
How did you hear about the Buddy Walk?
Family / Friend
Up with Down Newsletter
Registration Mailing
Up with Down Web Site
Newspaper Article
Poster / Brochure
Employer's Volunteer Web Site
Other  
 
Registration - Names of all participants
First & Last Name Age T-Shirts
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2.
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4.
5.
6.
7.
8.
9.
10.
 
Donations
Additional Donation: $
 
I am unable to participate in Buddy Walk, but I would like to make a donation of $
Waiver & Release of Liability
Waiver: In consideration of me and/or my minor child(ren) being permitted to participate in the 2008 Buddy Walk, I hereby for myself, my heirs and personal representatives assume any and all risks which might be associated with the event. I further waive, release, discharge and covenant not to sue the Up With Down Family Support Group, its officers, 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(ren) as a result of taking part in the events and any related activities. I also authorize the use by the Up With Down Family Support Group of any photo, film or videotape taken of me or my minor child(ren).
I understand and accept the waiver & release of liability agreement.


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