STROLLER WALK & TALK Event Registration
Register to participate in the STROLLER WALK & TALK event and complete all required agreements. Thank you for your interest in joining Stroller Walk & Talk, a weekly community walk hosted by Circle of Care Doula, Blessings Working Together, Inc., Fruits of Labor Prenatal & Postpartum Services, and K.A.R.E. After Birth Services. Our walks are designed to bring together pregnant mothers, postpartum mothers, families, caregivers, support persons, and their village for connection, encouragement, movement, and community. By completing this registration form, you will receive an invitation to join our WhatsApp community where we share event details, walking locations, weather updates, reminders, schedule changes, and special announcements.
First Name
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Last Name
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
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example@example.com
Emergency Contact Name
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Relationship to Participant
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Emergency Contact Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
WHATSAPP COMMUNITY ACKNOWLEDGMENT
I understand that Stroller Walk & Talk communications, reminders, location information, weather updates, and event announcements will be shared through the Stroller Walk & Talk WhatsApp Community.
I understand and would like to receive a WhatsApp invitation.
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I understand and would like to receive a WhatsApp invitation.
PHOTO & MEDIA RELEASE
I understand that photographs, video recordings, and/or audio recordings may be taken during Stroller Walk & Talk events for educational, promotional, marketing, social media, website, grant reporting, community outreach, and other organizational purposes. By participating in Stroller Walk & Talk, I grant permission to Circle of Care Doula, Blessings Working Together, Inc., Fruits of Labor Prenatal & Postpartum Services, and K.A.R.E. After Birth Services to use photographs, video recordings, and/or audio recordings that may include my image, likeness, voice, and/or the image or likeness of any minor child accompanying me.I understand that these materials may be used in print, digital, website, social media, promotional, educational, fundraising, and community outreach materials without compensation.
I have read and agree to the Photo & Media Release.
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I have read and agree to the Photo & Media Release.
PARTICIPATION WAIVER & RELEASE OF LIABILITY
I understand that participation in Stroller Walk & Talk is voluntary.I acknowledge that participation in outdoor walking activities involves inherent risks, including but not limited to slips, falls, uneven surfaces, weather conditions, physical exertion, interactions with other participants, and other unforeseen hazards.I voluntarily assume all risks associated with participation in this activity.I agree to assume full responsibility for my own safety and the safety of any children, family members, guests, caregivers, support persons, or other individuals accompanying me.I release and hold harmless Circle of Care Doula, Blessings Working Together, Inc., Fruits of Labor Prenatal & Postpartum Services, K.A.R.E. After Birth Services, their officers, directors, staff, volunteers, contractors, representatives, sponsors, partners, and affiliates from any and all claims, demands, causes of action, liabilities, injuries, damages, losses, costs, or expenses arising from or related to my participation in Stroller Walk & Talk.I certify that I am physically able to participate in this activity and understand that I may stop participation at any time if I feel unable to do so safely.
I have read and agree to the Participation Waiver & Release of Liability.
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I have read and agree to the Participation Waiver & Release of Liability.
ELECTRONIC SIGNATURE
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Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Registration
Submit Registration
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