2026 DSCNW Step UP for Down Syndrome Walk October 4th, 2026, Genesee City Park, Genesee, ID
Please fill out one waiver for your entire family.
Personal & Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name (if attendee is a minor)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact 1
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact 2
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please list family members/attendees and their ages:
Release
Acknowledgment of Risk
*
Acknowledgment of Risk. I, the undersigned participant, acknowledge that participation in the above event involves certain risks, including but not limited to physical injury, property damage, or other unforeseen hazards. I voluntarily assume all such risks associated with my and my family's participation.
Release of Liability
*
Release of Liability. In consideration of being permitted to participate in this event, I hereby release, waive, and discharge the event organizers, sponsors, volunteers, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury that may occur during or as a result of my and my family's participation.
Medical Treatment Consent
*
Medical Treatment. I consent to receive medical treatment deemed necessary in the event of injury, accident, or illness during the event. I understand that I am responsible for any medical expenses incurred.
Photography and Media Release
*
Photography and Media Release. I grant permission for the use of my image, likeness, or voice in photographs, videos, or other media taken during the event for promotional or informational purposes without compensation.
Participant Certification
*
Participant’s Certification. I certify that I am physically fit to participate in this event and have not been advised otherwise by a qualified medical professional.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Signature (if under 18)
*
Submit
Submit
Should be Empty: