DSSGC Columbia Basin Buddy Walk 2022 Registration

DSSGC Columbia Basin Buddy Walk 2022 Registration
How are you registering as part of the Buddy Walk? *

I am registering as an individual or family (No Team) I am registering as part of a team I am not registering but would like to make a donation
Contact Name *

First Name Last Name
Contact Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
E-mail *
Age *
Do You Have Down Syndrome? *

Yes No
My T-Shirt Size *
Buddy Walk Team
Are you the team captain?

Yes No
Select the team you are registering with, you can add a new team at the bottom of the list:
Buddy Walk Team Information
Select the team you are registering with, you can add a new team at the bottom of the list:
Team Captain's Name

First Name Last Name
Team Captain's Phone Number

Area Code Phone Number
Team Captain's Email
Does your team have a Buddy (individual who has Down syndrome)?

Yes No
Info About Buddy

If your team has a "Buddy", team captains should fill out the information below about your buddy. This should be completed whether are a returning team or a new team. Along the Buddy Walk route, we display posters of our buddies so that the community can get to know them better. These posters are yours to keep after the walk! Download a current photograph below or email a photo to cbbuddywalk@gmail.com.
Name

First Name Last Name
Age
Hobbies/Interests
My Buddy's T-Shirt Size
Team captains can upload an up-to-date photo of their Down Syndrome Buddy here.
Registration Fee & Donation
The cost to participate and walk in the Buddy Walk is $10. If you have Down Syndrome, the registration is FREE! Below you can pay for your registration fee and/or donate to a team. If you are completing multiple registration forms, you can pay for all the registrants on a single registration form.

If you would like to make a donation, simply check the registration box below and enter in the amount you would like to donate in the "Enter Desired Donation Amount" box. For instance, if you would like to donate $30, enter the number 30 in the box below. The total will be displayed below.
Family Members *
Online Registration & Donation (Registration fee not required if only making a donation)
prev next ( X )
Online Buddy Walk Registration Fee $ 10.00

Number of Registrants
Item subtotal: $ 0.00

Donation to Buddy Walk $ 1.00

Enter Desired Donation Amount

Total $ 0.00
Have you ALREADY PAID the registration fee on another form?

YES NO
If YES, please list the name of the payee:
First and last name
If you made a donation, Select "DONATE TO BUDDY WALK AS A WHOLE" -OR- Specify Desired Team For Pledge
Select A Team
I’d like to become part of the DSSGC family and be contacted about other programs/events

Yes, I’d like to become part of the DSSGC family and be contacted about other programs/events No, I don't want to become part of the DSSGC family and be contacted about other programs/events
Required Waiver: In consideration of me and/or my minor child being permitted to participate in the Columbia Basin Buddy Walk, I hereby, for myself, my heirs, and personal representatives, assume any and all risks which may be associated with this event. I further waive, release, discharge and covenant not to sue DSSGC, its officers, employees, sponsors, organizers, volunteers, or other representatives or their successors and assigns, for any and all injuries and 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 of DSSGC of any photo, film or videotape taken of
my or my minor child at the event for any purpose.
I have read the above waiver. Please sign below. *
Should be Empty:

DSSGC Columbia Basin Buddy Walk 2022 Registration

Buddy Walk Team

Buddy Walk Team Information

Info About Buddy

Registration Fee & Donation