TEAM
REGISTRATION

 
  • Please provide the following contact information:

     

    First Name*  
    Last Name*  
    Company  
    Street Address*  
    Address (cont.)  
    City*  
    State  
    Zip*  
    Team Name
    (if applicable)    		  
     Phone*   xxx-xxx-xxxx
    Other  Phone   xxx-xxx-xxxx
    FAX   xxx-xxx-xxxx
    E-mail*  

    * required

  • Please indicate your age and sex:
    Age  
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By clicking the "Register for the Hop" button below, I acknowledge submitting registration for the Ohio Cancer Research Associates Turkey Hop Walk and in consideration of the acceptance of my entry, I, for myself, my executors, administrators and assigners, do hereby release and discharge Ohio Cancer Research Associates, other sponsors and walk officials for all claims of damages, demands, actions, whatsoever in any manner, arising out of my participation in said event. I attest and verify that I have full knowledge of the risks involved in this event and I am physically fit and sufficiently able to participate in this event. Also I authorize the use of my name and/or photo taken at this walk for use in any news media or any form of publicity.

 

 

 


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Revised: July 27, 2006
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