Warriors Walk Pre-Registration

Personal Information: # of Years of Participation: *	* Required Fields
Name: *
Mailing Address: *
City: *
State: *
Zip: *
Telephone #: *
E-Mail: *
# of Additional Participants:
Adult Names:
Children Names / Ages:
Walking in Honor of: *
Branch of Service: *
Current Duty Station: *
T-Shirt:
Would you like to make a charitable donation? *	Yes No
Amount of charitable donation: Make Payable to: OMAD
Receipt Needed?	Yes No
I have read the Release Acknowledgment & Consent Statement below & agree to its terms: *	Yes No
My child / children may participate:	Yes No
Date: *

Release Acknowledgment and Consent

In consideration of OMAD's acceptance of this entry to the "Warriors Walk" event, I hereby release myself and my heirs, assigns, guardians, administrators and executors from liability and waive any and all claims for damages (whether for personal imjury, death, illness, property damage and/or property loss). This will include claims for negligence, which I may incur as a result of my participation in the "Warriors Walk" event, against the following: OMAD and its directors, volunteers, event sponsors and other participants in this event.

I acknowledge that I am in good health. I acknowledge that walking has natural risks, known and unknown, it is my intention to accept those risks and all consequences thereof.

I consent to the use of personal information contained in this registration form and photos of me from the event in any publicity associated with the event and in any form of promotional material for Operation Military Appreciation Day and the Warriors Walk.

In accepting this Registration Form, I acknowledge that I read the Release Acknowledgment and Consent in its entirety, that I understand and agree to be bound by its terms and that I accept without duress or undue influence from anyone.