Sneak Peek Walking Tour Registration
Tuesday, September 4, 2018
5:30 P.M. Downtown Salisbury Parking Garage (inside right of Circle Ave. entrance)
Registrant Information
Name *
Your answer
If registrant is under 18 years old, name of parent or guardian that will be accompanying them (each individual must be registered separately; no unaccompanied minors allowed).
Your answer
Phone number of Adult Participant /Parent/Guardian *
Your answer
Email address of Adult Participant /Parent/Guardian *
Your answer
Waiver & Permission
By completing this registration, I release the Wicomico County Health Department (WiCHD), the WalkWicomico (WW) coalition, all sponsors, licensees, successors, and assigns from all claims and liabilities of any kind arising out of my/my child's participation in this event. I assume all risks associated with me/my child walking in this event, including high heat, humidity, conditions of the walking areas, personal and traffic safety, etc. I also give permission for my/my child's words and/or likeness to be used in any/all media (i.e., digital, social, print, video) and publications (i.e., flyers, brochures, presentations) without approval of product from or payment for product to me. I understand WiCHD and WW assume no responsibility for the use of my/my child's words and/or likeness by the media to which it is submitted/posted, or by a third-party. I am at least 18 years and am competent to contract in my own name. I have read this release and understand its contents, meaning, and impact. *
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