Walk and Roll 2008



Online Registration: Family/Individual registration
you may also download a registration form to print and mail to us by clicking here.
Fields marked with a (*) are required.

Team Name:


Names of adults on team:
Your Name :
Adult (2):

+ add another adult

Names of children on team:
Child (1):	Age:
Child (2):	Age:
Child (3):	Age:
Child (4):	Age:

+ add another child

Address:

City:
State:
Zip:

Daytime Phone:
Evening Phone:

Email Address:

	I agree to allow Support for Families to use any photo, film or videotape of me/my family for any publicity or educational purpose. *(If you would prefer not to be photographed, please wear a colored sticker available at the Walk & Roll registration desk on the day of the event.)*

	Waiver: In consideration of being permitted to participate in Walk and Roll, I hereby for myself, my heirs and personal representatives assume any and all risks that might be associated with the event. I further waive, release, discharge and covenant not to sue Support for Families, its officers, employees, sponsors, organizers, volunteers or other representatives, or their successors and assigns, for any and all injuries or damages or any kind whatsoever suffered as a result of taking part in the event and any related activities.

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415-282-7494
2601 Mission St. #606, San Francisco, CA 94110

@ Open Gate Resource Center
415-920-5040
2601 Mission St. #300, San Francisco, CA 94110

@2007 Support for Families of Children with Disabilities