Group Registration and Waiver
Name of Group, School or Program
*
Adult Participant's Name
First Name
Last Name
Estimated Number of Volunteers
Child or Youth Participant
First Name
Last Name
Additional Child or Youth Participant
First Name
Last Name
Any additional child or youth participants
Please list.
Parent or Legal Guardian
First Name
Last Name
Email (@arizona emails are not accepted)
example@example.com
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Release of Liability and Waiver
This form is mandatory.
*
List all participants covered by this liability release
*
Waiver Signature
*
Date
*
-
Month
-
Day
Year
Date
Photo Release
Yes-unrestricted
No-deny permission
Photo Release Signature
Date
-
Month
-
Day
Year
Date
Demographic Information
TRAK relies on grants to support its programs. Grantors frequently ask us for the following information, and your response is completely optional. Thank you!
Ethnicity
Prefer not to answer
White
Black or African-American
Asian
Native American
American Indian or Alaskan Native
From multiple races
Other
Household income
Less than $10,000
$10,000-$24,999
$25,000-$49,999
$50,000-$74,999
$75,000-$99,999
$100,000-$149,999
$150,000 or greater
Prefer not to answer
Submit
Should be Empty: