2017 Team Registration Form

2017 Team Registration Form Walk of Hope Fundraiser Exercise Your Mind and Body Saturday, June 24th 2017

We will be meeting at 11am sharp at the Women’s Center in Willow. The address is 6595 Willow Fishhook Road, located 1-1/2 hours north of Wasilla. Where a bus ride will take you to the starting point, which begins up Hatchers Pass where we will walk a 5K back to the Women’s Center for the Rubber Ducky Race, barbeque and celebration. Along the walk there will be refreshment booths with energy snacks and water. If it is calling for rain please bring rain gear such as, extra pair of dry socks, shoes or rain boots and coat. We will be walking rain or shine. You may also choose to bring water bottles, snacks and a lunch. Dinner will be provided at the finish line along with music and celebration festivities.

By walking or sponsoring a walker, you become part of the AKDC team in the fight against addictions in Alaska.

______Yes, I would like to join the AKDC team and walk the full 5K.

______I am unable to participate in the walk but would like to join in the fight against addictions by donating $______

______I am unable to participate in the walk but would like to be a monthly pledge partner $______

______Corporate Match Donation $______

______Please email me a receipt

Name______E-mail______

Address______City______State ______Zip______

Home Phone______Cell Phone______

Registration fee of $25 can be paid on line through the AKDC Pay Pal (please memo what you are paying for) or make checks payable to Alaska Dream Center. See the Dream team sponsor form for details. We will also have on-site race day registration which opens at 11:00 am. Team Goals Each team member is encouraged to get as many sponsors as possible. Fundraising is fun and easy. Remember all fundraising comes down to is one word, ASK! Your friends, family, co-workers, businesses, acquaintances, schools, and corporations are all possibilities.

Liability Waiver; (please read carefully) In volunteering to participate in the Walk of Hope, I hereby agree that this activity shall be at my own risk against all casualties to myself or my property and that I take full responsibility of all risk of any kind no matter how caused. I hereby release and discharge the Alaska Dream Center, their staff and any other volunteer and indemnity of any actions, claims, demands, of every nature and kind. I grant organizers of this event permission to use photographs, images and quotations from me from this event.

Signature:______To register please email this form to [email protected] or fax to AKDC 907-746-3736

Thank you, for choosing to support the Alaska Dream Center in the battle against addictions!