Monumental Missions Walk 2016 Registration Form

Registration Instructions:

Form Instructions

 

Email Address Confirm Email Address

First Name Middle Last Name Suffix
Street Address (Line 1)
Street Address (Line 2, if applicable)
City State ZIP
Date of Birth (mm/dd/yyyy) Gender
Home Phone Mobile Phone
Emergency Contact's Name Emergency Contact's Phone

T-Shirt Size Which Church do you attend?
(Search by State - City - Church Name - Affliation)
(All Orthodox Churches within 250 miles of DC are included)		 (If other please specify)

Will you need bussing to local events? T-Shirt Size

LIABILITY WAIVER

I expressly acknowledge that I am holding harmless the organizers and sponsors of Monumental Missions Walk 2016 (including but not limited to the Metropolitan DC Orthodox Missions Committee, their members, employees, managers, owners and agents, and all their collective officers, directors, contractors, agents, employees, and volunteers, without regard to any negligence on their part, against any claim for injuries, damages, compensation or otherwise, including all losses and expenses, caused by or to me in registering for or participating in Monumental Missions Walk 2016  I voluntarily assume the risk of injury, accident, death, loss, cost or damage to my person or property that might arise from my registration for and/or participation in Monumental Missions Walk 2016 or any related events.  My refusal to agree to the terms of this waiver will result in my exclusion from all events and my registration fees being refused or refunded.  I understand that my registration will not be accepted without this acknowledgement.

Notes:

Select Package:

Select OnePackage NameItems IncludedPackage Cost

Items

SelectItemCostSubTotal
   Total Item Cost: $

Total Cost for this Registration: $

To help the organizers better plan for this event, please select all of the monuments which you are most interested in visiting. (Check all that apply)

What would you like to do?