Registration > Milpitas Registration

Milpitas Registration Form

Make it easy on yourself! To registration confirmation by mail, please pre-register February 12th. Remember, EACH participant must accept the waiver below (parent signature if under 18). To register by mail, please print out this page and mail to the address in Step 2. Step 1 *Register Yes, I want to participate in the walk and agree to the waiver below. * First Name * Last Name *Email * Address *City * State * Zip * Waiver Waiver: In consideration of your accepting my entry, I and any immediate family who registers in step 3, intending to be legally bound, do hereby for myself and my heirs, executors, administrators waive and release any and all rights and claims or damages I may accrue against the persons and organizations affiliated with the race for any and all injuries that may be suffered by me or enroute to or from the event. I attest that I am physically fit and sufficiently trained for this competition, my physical condition verified by a licensed M.D. during the last 6 months. As part of the waiver I acknowledge that I have read and understand all of the above. Step 2 The walk has the following registration fee: Min Entry fee for walk is $5 Kids & Seniors [> 60] walk free. *Payment Send check c/o International Association for Human Values 8226 Rinconada Court, Newark, CA 94560   Step 3 Include name(s) of immediate family members who are participating in the walk, in this box. Tell us about any special requests, concerns or questions you have about the walk. Someone from our staff will respond to you by email or phone.   Step 4 After you hit the send button (below), an email will be created. Please send this email and you will be sent an email reply to confirm that your registration form has been received. Once we receive your payment, you'll be officially registered for the Tsunami Walk 2005, Milpitas, CA. Don't forget to print out the pledge form below to increase your support for the Tsunami Reconstruction efforts. Thank you for your support. Send us this registration form by clicking this button:

For more information, please contact Jayashree @ 510 818 9900 or Suzanne @ 805 637 2898 or email us.

Send mail to iahv_milpitas@yahoo.com with questions or comments about this web site.