TRI-CITIES
HABITAT FOR HUMANITY
WALKER’S NAME:_________________________________________________________________
ADDRESS:_________________________________________________________________________
CITY_____________________________ ZIP ____________________TELEPHONE :____________
CHURCH/GROUP (IF APPLICABLE):__________________________________________________
I hereby waive and release any claims for damages, harm, or injury during the walk and rest stops. I understand the walk sponsors will not be liable for any loss, damage, injury or harm under any circumstances or acts of any kind by any persons. (Persons under the age of 18 will not be supervised during the walk and must have the signature of a parent or guardian).
SIGNATURE:__________________________________________________________
PARENT/GUARDIAN:(If applicable)_______________________________________
T-Shirt Size Medium Large Extra Large XXLarge (add an additional $3 for XXL) Circle one
Please include a $15 registration fee (make checks payable to Tri-Cities Habitat for Humanity) and return this form to:
Lisa Ellwood
TCHFH Spring Walk for Habitat
4705 Bromley Lane
Richmond, VA 23226
Pre-registration deadline is March 7. Pre-registration by this date will ensure you receive a T-shirt. Those who register after March 7th will NOT be guaranteed a t-shirt, but a registration fee is still required to cover our expenses.
Registration will be held at the Virginia State University Daniel Gym parking lot. For those who pre-register by mail, please arrive by 9:10 to sign in - the walk will begin promptly at 9:30. For those who are registering on the day of the walk, registration will begin at 8:45.
Walk will be held rain or shine.