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2024 周年筹款百萬行 / ASSIST Walk & Run 報名表 / Registration Form
日期 / Date: 2024 年 6 月 23 日（星期日）/ Sunday June 23, 2024
地點 / Place: Victoria Park: 12130 River Valley Rd NW
時間 / Time: 請十時前報到，上午十時三十分開步。
報名費 / Registration Fee: $10
Please report by 10:00am. Walk/Run starts at 10:30am
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Email
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Your email
姓 / Last Name:
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Your answer
名 / First Name :
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Your answer
Age
(If you are a youth under 18 years old, please fill the youth registration form.)
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Your answer
地址 / Address:
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Your answer
郵政編碼 / Postal Code
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Your answer
Contact number/ 電話號碼 / Tel:
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Your answer
T 恤衫/T-shirt: 免費 / Free 尺碼/Size:
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S
M
L
XL
2XL
I agree to pay the registration fee/ donation amount to ASSIST Community Services Centre (Head office or Southwest office), from June 17 – June 23, 2024 (10am – 5pm) in person or via
ASSIST e-transfer payment to
assist.pay@assistcsc.org
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Yes, already paid
Yes, will pay by June 23, 2024
放棄訴訟權利﹕當此報名表被接納後，我本人願意對華人社區服務中心、大會行政人員、裁判員或一切與此活動 有關的團體及個人，放棄一切訴訟及索償權利，並籍此證明本人健康及體力適合參與此次百萬行 /跑步活動。 Waiver: In consideration of this entry being accepted, I waive all rights of claims that I may have against ASSIST Community Services Centre, walk officials, administrators, or any other organizations or individuals associated with this event. I attest and verify that I am physically fit for participation in this event. 本人同意華人社區服務中心可以使用我在此次活動的照片、錄像、錄音等作公開或傳媒之用。 I give permission to have myself appeared in any public or media coverage, including but not limited to photographs, videotapes, recordings as approved by ASSIST Community Services Centre.
参加者簽名 / Signature of Participant：(Please write your full name)
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