Participant's Name (required) By checking this box I grant permission for the use of my name and/or picture in any broadcast, photography, print publication, website, video, social media or other accounts of Community Ministry for the Run/Walk Event.
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
Parent/Guardian Name By checking this box I affirm that I am the parent/guardian of the above participant and that I have explained to this participant their choice in this matter and further grant my permission for the use of the above participant's name and/or picture in any broadcast, photography, print publication, website, video, social media or other accounts of Community Ministry for the Run/Walk Event.
Your Email (required)
Submission of this form will record your electronic signature to this document as of the date of submission.
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