Hillcrest Transitional Housing Annual Walk for the Homeless

Register To Walk

Walk Site Information - Select your Hillcrest Affiliate and Event.

Select the site where you would like to walk:

Walk Participant Information

I am walking by myself as an Individual/Family
I am walking on a Team
I am a Team Captain

Team Members Only (Do Not use for Family):

Team Captain's Name:

Team Captains Only:

My Team's Name:

Team Pledge Goal: $

Log-in Information - Choose your Log-in User Name & Password.

Password:

Re-Enter Password:

Password Reminder Phrase - In case you forget your password, enter a phrase that will prompt a password reminder.

Hint Phrase:

Registrant Information For "Family", enter all first names separated by a comma into the First Name field

First Name:

Last Name:

Address:

Address Line 2:

City:

State:

Zip:

Email Address:

Home Phone:

Work Phone:

T-Shirt Size:

Family Shirt Sizes:

Please enter the rest of the Family walkers' T-shirt sizes below separated by commas:

My Pledge Goal: $

Waiver of Liability Agreement - I agree to the following:? YesNo

I/We hereby certify the following: (1) I/We am/are physically fit and have received, if necessary, medical clearance to participate in the Hillcrest Walk for the Homeless, (2) In being accepted, I/We, on behalf of myself, my heirs and assigns, and my estate, hereby waive and forever discharge the sponsors, organizers, affiliates, as well as their agents and employees from any and all claims that may accrue as the result of my participation, and (3) I/We hereby grant Hillcrest Transitional Housing specific permission to reproduce, publish, circulate, copyright or otherwise use any and all photographs and/or videoape of me and/or my family, taken at the Hillcrest Walk for the Homeless, for use by Hillcrest Transitional Housing.

Please describe briefly why you participate in Hillcrest's "Walk for the Homeless"

May we publish the above description on our web site? YesNo

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