Innovative Health and Fitness Health Club and Spa

BY SUBMITING THIS FORM
YOU AGREE TO THE FOLLOWING:
Entry and release of all claims in consideration of the acceptance of this entry in the Innovative Health & Fitness 2008 Walk Benefiting the Franklin Educational Foundation, I hereby for myself and all listed family members, my executors and administrators, waive any and all claims for damages I may have against FEF, IHF, City of Franklin, Milwaukee County, Franklin School District, and individuals associated with event, their representative, successors and assignees, will be held harmless for any and all injuries suffered in connection with said event. I must be in good health to participate in ths event. In filling out out this form, I acknowledge that I am an amature in such events. I consent to the use of my name, photograph, likeness or image for any ligitimate purpose. I further acknowledge that elementary age students and under must be accompanied by an adult. I acknowledge I have read and fully understand my own liability and do accept the restrictions.

PARTICIPANT #1
(1) First Name:
*
(1) Last Name:
*
(1) Gender:

(1) Age:

(1) Name of School:

(1) Grade:

(1) Event:

(1) T-Shirt Size:

(1) Fee:

PARTICIPANT #2
(2) First Name:
(2) Last Name:
(2) Gender:

(2) Age:

(2) Name of School:

(2) Grade:

(2) Event:

(2) T-Shirt Size:

(2) Fee:

PARTICIPANT #3
(3) First Name:
(3) Last Name:
(3) Gender:

(3) Age:

(3) Name of School:

(3) Grade:

(3) Event:

(3) T-Shirt Size

(3) Fee:

PARTICIPANT #4
(4) First Name:
(4) Last Name:
(4) Gender:

(4) Age:

(4) Name of School:

(4) Grade:

(4) Event:

(4) T-Shirt Size:

(4) Fee:

PARTICIPANT #5
(5) First Name:
(5) Last Name:
(5) Gender:

(5) Age:

(5) Name of School:

(5) Grade:

(5) Event:

(5) T-Shirt Size:

(5) Fee:

PARTICIPANT #6
(6) First Name:
(6) Last Name:
(6) Gender:

(6) Age:

(6) Name of School:

(6) Grade:

(6) Event:

(6) T-Shirt Size:

(6) Fee:

HOUSEHOLD INFORMATION
(hi) First Name:
*
(hi) Last Name:
*
(hi) Street Address
*
(hi) Street Address 2:
(hi) City:
*
(hi) Zip Code:
*

Phone Number:
*
Email:
*

I acknowledge I have read and fully understand my own liability and do accept the restrictions.
Security code:
*
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