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Please fill out the following form to pre-register for Cross Roads Pregnancy Care Center's
2018 Walk For Life • October 13, 2018
First Name
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Last Name
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Address
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City
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State
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Vermont
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Washington
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Washington DC
Zip Code
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Phone Number
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Email Address
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Church/School/Group Affiliation
I am:
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Adult
Child
Shirt Size needed:
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Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
I would like to volunteer at the 2018 Walk For Life.
By submitting this form, I waive all claims for myself and my heirs against the Cross Roads Pregnancy Care Center for any injury or illness which may result directly or indirectly from my participation. I also give this organization permission to use photographs of me taken at the Walk for Life and associated events in future event promotion.
(Initial Here) I have read and agree to this waiver.
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