Alzheimer Society of Windsor and Essex County

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Please provide a name and email address for a parent or guardian, they will need to sign off for you.
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PARTICIPANT RELEASE AND WAIVER

In consideration of the Alzheimer Society permitting me to participate in this event, I hereby, for myself, executors, administration and personal representatives, release the organizers of this event, their agents and volunteers, the event sponsors, and the Alzheimer Society from all liability claims of any kind whatsoever that I might have for personal injuries or property losses suffered by participation in this event. I certify I have full knowledge of the risks involved in this event, that I am physically fit and able to participate, and unless indicated to the contrary by the signature of the guardian below, I am 18 years or older.

By giving the Alzheimer Society permission to use my name and photo in media promotional materials I am helping to build awareness that will bring the Society closer to its vision of a world without Alzheimer’s disease and dementias. Photos and videos from the Walk may also be used to help the Society promote the event in flyers, brochures, and other materials.

Check here to show you accept the terms stated above for yourself or for a minor volunteer for which you are a parental guardian.
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