HERITAGE DAY REPRISAL - REGISTRATION

HERITAGE DAY REPRISAL - REGISTRATION

PLEASE COMPLETE FOR THE FOLLOWING: RUN/WALK -FOOD TRUCK VENDOR - MERCHANDISE VENDORS
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PLEASE SELECT FROM THE OPTIONS BELOW AND PROCEED TO THE APPROPRIATE SECTION
VENDORS - Please state your business name and briefly describe your product.
Payments can be made online at JEWJCC.ORG (Donate)
HEALTH WALK WAIVER (must be signed by all participants)

I agree that I am participating in the JEWJCC HEALTH WALK LIVE DOWN & AROUND REV WENDELL ANTHONY DRIVE in association with the James E. Wadsworth, Jr. Community Center (JEWJCC) Heritage Day Reprisal event.

I understand that this is a voluntary effort and that I am fully responsible for my health, well-being, and ability to participate. I take full responsibility for my actions.

Furthermore, I agree to hold harmless the JEWJCC nor anyone acting on its behalf, including but not limited to; its Director, Board of Directors, staff, volunteers, Fellowship Chapel church, and its affiliates in the event of injury or death while participating to the extent allowable by law.
I have read the Waiver and am signing off in agreement to the above statement.
For more information or if you have questions please email us at JEWJCC@COMCAST.NET

We will respond within 48-hours.
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