Walk of Love Registration

Please complete the below form to register for Walk of Love on September 10^{th^.}

1Registration Sign Up

2Additional Registrants

3Release of Liability

4Billing

Hidden
Prefill
Participant 1
Name Participant 1*
First Last
Email*
Phone*
Participant 1's Date of Birth*
MM slash DD slash YYYY
Will You or Anyone Participate Virtually and Need their Shirts Shipped?
Please note a $5.00 Charge for Shipping and Handling per form.
- Yes, Please Ship - $5.00
- No, I will pick up at The Brittany's Hope Office
- No, We will all be Attending
Participant 1's Walk*
- Fun Walk - In Person - $15
Does Participant 1 Want to Join a Team?
Click on the dropdown to choose your team
Participant 1's Team Name
Participant 1's shirt size

Additional Participants
How many additional participants would you like to register?*
Will Anyone Participate in the Kid Fun Run?

Yes

No
Please List the Names of the Kid Fun Run Participants

Note, you will still need to fill out their information below.
Participant 2
Name of Participant 2
First Last
Participant 2's Date of Birth
MM slash DD slash YYYY

Choose Participant 2's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 2 Want to Join a Team?
Click on the dropdown to choose your team
Participant 2's Team Name

Participant 2's shirt size
Participant 3
Name of Participant 3
First Last
Participant 3's Date of Birth
MM slash DD slash YYYY

Choose Participant 3's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 3 Want to Join a Team?
Click on the dropdown to choose your team
Participant 3's Team Name

Participant 3's shirt size
Participant 4
Name of Participant 4
First Last
Participant 4's Date of Birth
MM slash DD slash YYYY

Choose Participant 4's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 4 Want to Join a Team?
Click on the dropdown to choose your team
Participant 4's Team Name

Participant 4's shirt size
Participant 5
Name of Participant 5
First Last
Choose Participant 5's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Participant 5's Date of Birth
MM slash DD slash YYYY

Does Participant 5 Want to Join a Team?
Click on the dropdown to choose your team
Participant 5's Team Name

Participant 5's shirt size
Participant 6
Name of Participant 6
First Last
Participant 6's Date of Birth
MM slash DD slash YYYY

Choose Participant 6's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 6 Want to Join a Team?
Click on the dropdown to choose your team
Participant 6's Team Name

Participant 6's shirt size
Participant 7
Name of Participant 7
First Last
Participant 7's Date of Birth
MM slash DD slash YYYY

Choose Participant 7's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 7 Want to Join a Team?
Click on the dropdown to choose your team
Participant 7's Team Name

Participant 7's shirt size
Participant 8
Name of Participant 8
First Last
Participant 8's Date of Birth
MM slash DD slash YYYY

Choose Participant 8's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 8 Want to Join a Team?
Click on the dropdown to choose your team
Participant 8's Team Name

Participant 8's shirt size
Participant 9
Name of Participant 9
First Last
Participant 9's Date of Birth
MM slash DD slash YYYY

Choose Participant 9's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 9 Want to Join a Team?
Click on the dropdown to choose your team
Participant 9's Team Name

Participant 9's shirt size
Participant 10
Name of Participant 10
First Last
Participant 10's Date of Birth
MM slash DD slash YYYY

Choose Participant 10's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 10 Want to Join a Team?
Click on the dropdown to choose your team
Participant 10's Team Name

Participant 10's shirt size
Participant 11
Name of Participant 11
First Last
Participant 11's Date of Birth
MM slash DD slash YYYY

Choose Participant 11's Walk*

Fun Walk - In Person - $15

Fun Walk - Virtual - $15
Does Participant 11 Want to Join a Team?
Click on the dropdown to choose your team
Participant 11's Team Name

Participant 11's shirt size

Release of Liability
This PARTICIPANT/VOLUNTEER RELEASE AND WAIVER OF LIABILITY (this “Release”) is executed as of this 10th day of September 2023 by ____________________________ [PARTICIPANT NAME] (”I” or “me”) in favor of Brittany’s Hope, a not-for-profit corporation organized and existing under the laws of the Commonwealth of Pennsylvania, and its directors, officers, employees, volunteer staff, and agents. I desire to participate and engage in activities and/or will be a volunteer participating in the activities related to the charitable event titled above sponsored by Brittany’s Hope (the “Activities”). I understand that the Activities may include, but are not limited to, biking, walking, running, hiking, participating in games and athletic contests, and festival games and activities. I also understand that as a participant/volunteer, I will receive no compensation or remuneration for my services and will not be eligible for any employee benefits. I acknowledge that I am not an employee. In exchange for being allowed to participate in the Activities as a participant and/or volunteer and for other good and valuable consideration, the receipt and sufficiency of which I acknowledge, I hereby freely, voluntarily, and without duress execute this Release and agree to the following terms: 1. Assumption of Risk. I am aware and understand that the Activities may be inherently dangerous and may expose me to a variety of foreseen and unforeseen hazards and risks. These risks may include but are not limited to athletic activities which can be an extreme test of a person’s physical and mental limits. Further risks may include, but are not limited to dangers from or caused by terrain, facilities, temperature, weather conditions, other participants and volunteers, spectators, coaches, event officials, event monitors, event sponsors, and problems with hydration and/or food-related issues. I acknowledge that I am voluntarily participating in and/or volunteering to run the Activities and have considered those risks. I hereby expressly and specifically assume such risks, including any and all risk of injury, harm, or loss that I may incur as a result of my participation in the Activities. 2. Medical Condition and Treatment. I certify that I am physically fit, have sufficiently trained for participation in the event and have not been otherwise advised by a qualified medical person. I hereby give consent and authority to Brittany’s Hope and any of its directors, officers, employees, volunteer staff, and agents to obtain medical treatment on my behalf if I am injured or require medical attention during my participation in the Activities. I understand and agree that I am solely responsible for all costs related to such medical treatment, medical transportation, and/or evacuation. I hereby release, forever discharge, and hold harmless Brittany’s Hope and its directors, officers, employees, volunteer staff, and agents from any claim whatsoever in connection with such treatment or other medical services. 3. Release and Waiver. I hereby fully and forever release and discharge Brittany’s Hope, Stone Gables Estate, LLC, DAS Companies, Inc., DAS Real Properties, LLC, and David Abel and Tierney Abel, and their respective directors, officers, employees, volunteer staff, and agents (the “Released Parties”) from, and expressly waive, any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, that may arise from my participation in the Activities. I covenant not to make or bring any such claim or demand against the Released Parties, and fully and forever release and discharge the Released Parties from liability under such claims or demands. I UNDERSTAND THAT THIS RELEASE DISCHARGES THE RELEASED PARTIES FROM ANY LIABILITY OR CLAIM THAT I MAY HAVE AGAINST THE ORGANIZATION WITH RESPECT TO ANY BODILY INJURY, PERSONAL INJURY, ILLNESS, DEATH, PROPERTY DAMAGE, OR PROPERTY LOSS THAT MAY RESULT FROM THE ACTIVITIES, WHETHER CAUSED BY THE NEGLIGENCE OF THE ORGANIZATION OR OTHERWISE. 4. Insurance. I UNDERSTAND THAT THE ORGANIZATION AND THE RELEASED PARTIES DO NOT ASSUME ANY RESPONSIBILITY FOR OR OBLIGATION TO PROVIDE FINANCIAL ASSISTANCE OR OTHER ASSISTANCE, INCLUDING BUT NOT LIMITED TO MEDICAL, HEALTH, OR DISABILITY INSURANCE OF ANY NATURE IN THE EVENT OF MY INJURY, ILLNESS, OR DEATH, OR DAMAGE TO OR LOSS OF MY PROPERTY. I also understand that workers’ compensation insurance is not available to volunteers and that the Organization does not provide workers’ compensation insurance for volunteers. I expressly waive any claim for compensation or liability on the part of Brittany’s Hope in the event of any injury or medical expense. 5. Indemnification. I hereby agree to indemnify, defend, and hold harmless the Released Parties from any and all liability, losses, damages, judgments, or expenses, including attorneys’ fees, that it may incur or sustain as a result of my negligence, recklessness, or willful misconduct in connection with my participation in the Activities or which may arise out of the actions or inactions of the Released Parties. 6. Photographic Release. I understand and agree that during the Activities, I may be photographed and/or videotaped by Brittany’s Hope for internal and/or promotional use. I hereby grant and convey to Brittany’s Hope all right, title, and interest, including but not limited to, any royalties, proceeds, or other benefits, in any and all such photographs or recordings, and consent to Brittany’s Hope’s use of my name, image, likeness, and voice in perpetuity, in any medium or format, for any publicity without further compensation or permission. 7. Miscellaneous. I hereby agree that this Release represents the full understanding between Brittany’s Hope and me and supersedes all other prior agreements, understandings, representations, and warranties, both written and oral, between us, with respect to the subject matter hereof. If any term or provision of this Release shall be held to be invalid by any court of competent jurisdiction, that term or provision shall be deemed modified so as to be valid and enforceable to the full extent permitted. The invalidity of any such term or provision shall not otherwise affect the validity or enforceability of the remaining terms and provisions. This Release is binding on and inures to the benefit of Brittany’s Hope and me and our respective heirs, executors, administrators, legal representatives, successors, and permitted assigns. Section headings are for convenience of reference only and shall not define, modify, expand, or limit any of the terms of this Release. 8. Governing Law. I hereby agree that this Release is intended to be as broad and inclusive as permitted and that this Release shall be governed by and interpreted in accordance with the laws of the Commonwealth of Pennsylvania, without reference to any choice of law doctrine. BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE ORGANIZATION.
Agreement*
I Agree to the Release of Liability

Billing Information
Name*
As it appears on your card.
First Last
Phone*
Email*
To receive your receipt

Contact Me About Volunteering or Sponsorships

Join Our Email List
Yes for Brittany's Hope
Yes for Walk of Love
No thank you
Go Above & Beyond

Discount Code

Please Enter Company Name

Today's Total
$0.00
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is the Shipping Address the Same as Billing?

Yes

No
Shipping Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Please complete the below form to register for Walk of Love on September 10th.

Participant 1

Additional Participants

Participant 2

Participant 3

Participant 4

Participant 5

Participant 6

Participant 7

Participant 8

Participant 9

Participant 10

Participant 11

Release of Liability

Billing Information

Please complete the below form to register for Walk of Love on September 10^{th^.}