LOWER MAINLAND DOWN SYNDROME SOCIETY
12TH ANNUAL T21 WALK FOR AWARENESS
SEPTEMBER 9TH, 2017
TEAM FORM
FOR TEAM CAPTAINS TO KEEP A RUNNING TOTAL FOR THEIR TEAM ($5.00 Before Sept 1,
2017, $10.00 After Sept 1st, 2017)
NAME OF TEAM (Please Print): ___________________________________________________
Team Captain(s): _______________________________________________________________
_______________________________________________________________
TEAM PLEDGES HANDED IN:
Team Members Name
CASH
CHEQUES
TTOTTOTALS
$
TOTAL CASH
$
TOTAL CHEQUES
$
GRAND TOTAL
COLLECTED
$
Waiver: By adding your name to the above list you hereby acknowledge that you understand the intent thereof, and you hereby agree and absolve
and hold harmless the Lower Mainland Down Syndrome Society, corporate sponsors, cooperating organizations and any other parties connected
with this event in any way singly, or collectively from and against any blame and liability for any injury, misadventure, harm, loss, inconvenience
or damage hereby suffered or sustained as a result of participation in any activities organized by Lower Mainland Down Syndrome Society.
Authorization for the use of photos and name(s): By adding your name to the above list you are authorizing the Lower Mainland Down
Syndrome Society to use any photos of yourself, or family including a minor under your custody or an adult for whom you are authorized to
make decisions for. You authorize photos to be used by the LMDSS for the purpose of social media, pamphlets, newspaper ads, website or any of
the foregoing. I understand that by giving my consent to this will mean that no financial payment will be made to me by the LMDSS.
THIS TEAM FORM IS NOT VALID UNLESS SIGNED BY EACH TEAM MEMBER
HAVE ANY QUESTIONS? NEED MORE INFO?
Just call or email us. We would be happy to help!
CONTACT US: 604-591-2722 / [email protected]