ALS of Michigan

ALS of Michigan Logo

Where will you be walking?

First Name

Last Name

Mobile Number

Address

City

State

Zip

T-Shirt Size

pALS (person with ALS) you are walking for

Waiver

I Hereby Waive All Claims Against Als Of Michigan, Sponsors Or Personnel For Any Injury That I May Suffer From My Participation In This Event.

I grant full permission for organizers to use photographs, videotapes, motion pictures, recordings or any other record of this event in which I may appear for any legitimate reason. Having read this waiver and knowing these facts, and in consideration of this acceptance of my entry, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waiver, release and discharge ALS of Michigan, event officials, volunteers, and any other sponsors, suppliers, agents, independent contractors, employees and other personnel in any way assisting or connected with this event.