Online Registration

Courage to Connect Awareness Walk

Registration Form
Join the Adams County Health Action Team (ACHAT) for Adams County’s first Courage to Connect community walk! Connect with your neighbors, learn about local organizations and their resources supporting the health of Adams County, and enjoy the fresh air. Participants are welcome to travel the 1 mile or 5k out and back distances. If you are signing up someone else on their behalf, you will need to complete an additional form. Individuals who pre-register will receive a resource bag at the event!

If you're interested in volunteering, being a part of the Courage to Connect planning committee, joining ACHAT, or making a donation - we would love to hear from you! Please use this form to let us know you are interested. Someone will be contact to share more.
Name

First NameLast Name
Age
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
example@example.com
Phone Number
By submitting this form, I acknowledge that I am voluntarily participating in the Courage to Connect Community Walk and understand that such participation involves inherent risks. I hereby assume full responsibility for any and all risks of injury, loss, or damage that may occur as a result of my participation. I release and hold harmless any organizations associated with the Adams County Health Action Team and this walk, its officers, employees, and affiliates from any and all liability, claims, or demands arising out of or related to my involvement. I confirm that I have read, understood, and agree to the terms of this waiver.

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In addition to signing up for the walk, I am interested in

Volunteering for the Courage to Connect WalkBeing part of the Courage to Connect planning committeeBeing a member of the Adams County Health Action Team (ACHAT)Making a donation to ACHATHosting a booth/table for my organization
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Courage to Connect Awareness Walk