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I'll/we'll
be walking on Sunday, May 1, 2011 in Van Nuys, CA |
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I'll/we'll
be walking on Sunday, May 1, 2011 in Fresno, CA |
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I'll/we'll
be walking on Saturday, May 14, 2011 in Berkeley, CA |
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I'll/we'll
be walking in honor of: |
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Name
of Individual with PWS, Family or Team
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Please
Print |
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Names
of All Walkers: |
Age
of Minor Walkers: |
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1.
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2.
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3.
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4.
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5.
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6.
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Walker
Fees |
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Individual
Walker: $20 ($25 on day of event)
Individual fee waived for sponsorships in excess of
$100
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Family
Walkers: $50 ($60 on day of event)
Family Fee waived for sponsorships in excess of $200 |
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Print
this form and mail with your check made payable to Prader-Willi
California Foundation at 514 N. Prospect Avenue, Suite 110-LL, Redondo Beach, CA 90277. |
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Total
Amount Enclosed: |
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Check
# |
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Southern
California Walkers, please return Walker Registration
Form by April 26, 2011. Sponsor donations will be gratefully
accepted throughout the year!
Walkers may use the Sponsor Form to track all of your
sponsors and their contributions.
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My
company has a matching funds program. |
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Please contact my employer at: |
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Please
contact me about volunteering opportunities |
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Walk
Waiver & Release-Please Read and Sign |
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I,
the undersigned, do waive any and all claims for myself
and my heirs, executors, and administrators and release
any and all rights and claims for damages I have against
Prader-Willi California Foundation (PWCF), PWCF Walk
sponsors and volunteers of this Walk for any illness
or injury which may directly or indirectly result from
my participation in the Walking for Prader-Willi
Syndrome event. I hereby grant full permission to
use my photographs of my participation in the event
for any publicity and/or promotional purposes without
obligation or liability to me. I understand that in
the event this Walk cannot be held as scheduled
due to an act of God or circumstances beyond control,
PWCF is not liable to refund any money paid to participate
or sponsorships collected. I will not overextend or
overexert myself. I am voluntarily entering in this
event at my own risk.
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