Walk Across Tennessee - HTN Tipton 2019
Individual Registration Form - this form must be submitted before beginning program
Email address *
Name *
Your answer
Address *
Your answer
Age *
If 17 and under, name of parent or guardian
Your answer
Gender *
My personal goals for participating are (check all that apply) *
Team Captain’s name (first & last) *
Your answer
Team Name *
Your answer
Shirt Size - First 90 registrants will receive a free t-shirt - SIZES NOT GUARANTEED
I wish to participate voluntarily in the Walk Across Tennessee physical activity for the purpose of personal fitness. I understand that I should have medical approval from my health care professional if I have any condition, chronic disease, or acute illness that would possibly inhibit or negatively affect my ability to participate in an exercise program. By typing my full name in the box below I agree to this waiver and agree to accept full responsibility for any injuries I may sustain while participating in this program and hold harmless all Sponsoring Parties. *
Your answer
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