ENROLLMENT FORM
Name:______________________________________________
Address:____________________________________________
____________________________________________________
Telephone Home:_________________Cell:_________________
Birthday:
Month____________ Day__________
RESPONSIBILITY WAIVERE
I,_______________________________________________,
accept to participate of all the events and activities of the of Plaza
Las Americas’ mall walkers club “Caminantes de Plaza”.
I
release Plaza Las Americas, Inc., the Department of Recreation
and Sports, sponsors, collaborators, and any other personnel for
any accident or injury I may suffer. By these means, I declare
that I am physically fit and prepared to participate in this event or
activity. I am well aware of the risks and types of injuries
associated with this kind of event or physical activity.
Signature:____________________________________________
Date:__________________________