Embarcadero Lions Club presents the 5th Annual

Robert G Smith Walk to

Cancel Out Parkinson's

Saturday, September 18 2021

Maidu Regional Park - Roseville, CA

For problems or questions
regarding online purchases
Contact: Warren Strand
wwstrand@rgsmith.org or
(530) 409-9113

2021 Registration

1

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Registrant(s) Information Entry

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Last Name

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T-Shirt Size

18+ Years

 

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Team Info
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Event Waiver

In Consideration of your accepting this entry, I, intending to be legally bound, do hereby for myself and my heirs, executors, administrators waive and release, any and all rights and claims or damages I may accrue against the persons and organizations affiliated with the walk for any and all injuries that may be suffered by me during the event. As part of this waiver I acknowledge that I have read and understand the above.

If Participant is a minor, the parent or guardian must agree to the below:
I am the legal guardian of Participant, and I hereby consent to his/her participation. I have read the foregoing agreement, and I hereby agree on behalf of myself and Participant to its terms.

Registration Info