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We're so glad you can join us!

Please take a few moments and fill out this registration form to complete your registration.

Registration For Events or Activities in 2019

*This event registration is good for all Parent to Parent and Walla Walla Valley Disability Network events and activities for 2019.*

Participant's Gender
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Medical Information
Does the participant take medication? (Information is needed in case of emergency)

Liability Release & Hold Harmless Agreement **Please read carefully**

I understand there are special dangers and risks inherent in Parent to Parent (P2P) and Walla Walla Valley Disability Network (WWVDN) activities, including but not limited to the risk of physical injury, death or other harmful consequences which may arise directly or indirectly from participation in these activities. Being aware of said risks I knowingly and voluntarily give my consent for the participant named at the beginning of this form to participate in P2P/WWVDN Activities in 2019, sponsored and supported by the Walla Walla Valley Disability Network.

Being fully informed as to the risks and in consideration of the Walla Walla Valley Disability Network and Parent to Parent allowing the participant to participate in these sponsored activities I, on my own behalf, and on behalf of the participant, assume all risk of injury, damage and harm to me or to the participant, which may arise from my or the participant's voluntary participation in this activity or use of community facilities.

I further agree to release and hold harmless the Walla Walla Valley Disability Network, its officials, staff and volunteers from any harm caused to me or the participant and which arises or is caused by the negligence of the Walla Walla Valley Disability Network, its officials, staff, volunteers, and agents. I hereby waive any right I or the participant may have to bring a claim or lawsuit for damages against the Walla Walla Valley Disability Network and Parent to Parent for any personal injury, death, or other harmful consequence occurring to me or the participant, or our personal property, arising out of participant's voluntary participation in this activity.

By entering my full legal name below I acknowledge that I have read, understood, and do hereby accept the conditions of this LIABILITY RELEASE & HOLD HARMLESS AGREEMENT, as stated above.

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Consent

I further provide my consent that pictures may be taken of the participant named above and used by the Walla Walla Valley Disability Network and Parent to Parent for promotional purposes and I acknowledge that I expect no compensation in return.

Allowed uses of photos - please check all that apply
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