5k Walker Registration

5k Online Registration

25.00

Save $5 on the early bird online registration! Registration Fee: Children Under 12: Free 13 Year & Older: $25
Processed through Paypal.

If you don't wish to pay through Paypal or online, please send a check and a printed registration form to
Fana Global Foundation
P.O. Box 11683
Newport Beach, California 92658

Please fill out the form below to complete registration for each walker.
Thank you for your generous heart!

Federal Tax Exempt Corporation EIN: 27-2909571
501(c)(3) Public Charity Status: 170 (b) (1) (A) (vi)
Effective Date of Exemption: May 14, 2010

Walk Registration

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Name *

First

Last

Age *

Email *

Phone Number *

Address *

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City

State

Zip Code

Country

Emergency Contact *

T-Shirt Size *

Preferred Payment Method *

Other *

Fana Global Foundation - WALK-A-THON Liability Waiver With the full knowledge and appreciation that walking can be a hazardous activity, I assume all risks associated with participation in the Fana Global Foundation's Children Wellness Worldwide- Transforming Hunger & Obesity walk-a-thon and hereby release, waive and hold harmless Fana Global Foundation, the sponsors, the volunteers, and officers, employees, agents, representatives, successors, and assigns from any and all liability or responsibility for injuries and/or property damage which I may sustain during the event or during my travel to or from the event. This waiver and release covers myself (including all heirs, executors, or administrators) and is given in consideration of the Fana Global Foundation's acceptance of my registration/entry into the event. In addition I agree to defend and indemnify Fana Global Foundation from any claim or action filed by a third party due to my actions in this event. I also attest that I am physically fit to participate in the walk-a-thon. Further, I agree to abide by the rules and regulations of the event. I have read and fully understand this Liability Waiver. Parent/Guardian Release for a Minor Under 18 Years of Age: I understand and agree that if I am signing this Waiver/Release on behalf of my minor child, that I will be giving up the same rights (as indicated for adults in the above statement) for said minor as I would be giving up if I signed this document of my own behalf. I acknowledge that I have read this Waiver/Release Agreement and that I understand the words and language in it. I have been advised of the potential dangers incidental to participating and/or receiving instruction in the Walk-a-thon. Agreement: By submitting this application, it will be stated that the facts set forth in it are true and complete. * Please be sure to pay for all walkers ages 13+ at the top of the page *

I have read and understand the Agreement and Waiver and fully understand its terms.

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