shcinc/save-our-homes-walk-registration

Save Our Homes Walker Registration

16th annual walk to prevent homelessness in Somerville
Date: Sunday, June 9, 2019

Time: Registration 1:30 pm / Walk 2:00 pm

Start: Somerville City Hall, 93 Highland Ave, Somerville
Walker's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Birthdate

MonthDayYear
Date
I am walking with...
If not walking with a team, write n/a
Total Amount Pledged
optional
Walker's signature/Parent or Guardian signature for Walkers under the age of 18

First NameLast Name
Please Read: Submission of this entry constitutes an acknowledgement that the walker is physically able to undertake the Walk and is a waiver of any and all claims arising our of the Walk that the walker might assert against any parties connected with the Walk. In addition, the walker assents to the use of any photo, film, or videotape of event for any purpose.

Please make all checks payable to: Save Our Homes Walk
For more information call Matthew at

617-623-6111 or visit saveourhomeswalk.org
Should be Empty:

Save Our Homes Walker Registration