Red Ribbon March & Rally

Event Date: Friday, October 23, 2026

Please complete this form for your child's participation in the 2026 Red Ribbon March & Rally, including the walk from the Charles Martin Youth Center (CMYC) to the Kroc Center.

Sign in to Google to save your progress. Learn more
1.  Student Information *
Please provide the following student information
Child's name, Parent/Guardian name, Phone number and Address
Child's T-shirt Size
Clear selection
Adult T-shirt Size
Clear selection
2.  Emergency Contact Information *
Please provide the emergency contact name, emergency contact phone number and emergency contact address.

3.  Permission, Medical Authorization & Liability Acknowledgement

 *

Permission, Medical Authorization & Liability Acknowledgment

I give permission for my child to participate in the 2026 Red Ribbon March & Rally on Friday, October 23, 2026, including the walk from the Charles Martin Youth Center (CMYC) to the Kroc Center. I understand my child must follow instructions from event organizers, staff, volunteers, and chaperones and behave respectfully and safely.

I understand the event includes an outdoor community walk and/or bus transportation pick-up/drop-off locations, and reasonable precautions will be taken for participant safety. If I cannot be reached in an emergency, I authorize event staff, volunteers, or emergency personnel to obtain necessary medical treatment for my child. I understand that I am responsible for any related medical expenses.

I understand participation in community events and walking activities involves risks, including accidental injury, weather conditions, or unforeseen circumstances. I acknowledge these risks and agree that the organizing entities and their representatives will not be held liable except in cases of gross negligence or willful misconduct.

Required
4.  Photo/Video/Media Release
 *
I give permission for my child to be photographed, filmed, or included in media coverage for educational, promotional, programmatic, and community-awareness purposes.
5.  Parent/Guardian Certification *
I certify that I am the parent/legal guardian of the child listed above and that the information provide is accurate to the best of my knowledge.    Please provide the following:  PRINTED parent/guardian name, parent/guardian signature with date.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms