Guns Down, Gloves Up Registration Form

Guns Down, Gloves Up Registration Form

Guns Down, Gloves Up Registration Form

Stop the Violence Walk
Location: Augusta Boxing Club

Walk Begins: 9:30 am

Registration Begins at 8:30am if not registered online.

🟣 Hosted by 2nd Time Around Developmental Resources Inc. in partnership with Augusta Boxing Club.
Join us as we stand against gun violence and create opportunities for our youth.
“Turning Pain into Progress and Power.”
Contact Info
Full Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Number of Participants
Emergency Contact Person

First NameLast Name
Emergency Contact Phone Number
Format: (000) 000-0000.
Relationship to Emergency Contact
Registration Payments

Family Registration: $25.00 per family (covers up to 5 members)

USDDescription

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Payments are accepted by cash app, zelle or credit/ debit card. Please add name in "for" line.
Waiver & Release
I, on behalf of myself, my heirs, executors, administrators, and assigns, hereby release, waive, and discharge 2nd Time Around Developmental Resources Inc., Augusta Boxing Club, and all officers, directors, members, volunteers, sponsors, partners, and affiliates from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, injury, or death that may be sustained while participating in the Event:
Participant's Signature
Date Signed

MonthDayYear
Date
Parent/Guardian Signature (If participant is below 18 years old)
Should be Empty: