Samaritan Caregivers uses caring volunteers to provide free, non‐medical help to people 65+ living at home in Howard County, IN to help them maintain independent living. Respite Care—
Transporta on — Personal Shopping—
Companionship — Handyman Volunteers are re rees, people s ll working, families, youth, clubs, church groups, business employees, service organiza ons. Volunteer regularly or occasionally. SamaritanCaregivers
2705S.BerkleyRoad,Suite3C
Kokomo,IN46902
Phone:765.453.7611
Fax:765.453.7625
E‐mail:[email protected]
Website:
www.samaritancaregivers.org
Join us on Sunday, August 23, 1:30 PM for the 2nd annual Banjo Boogie Walk. BanjoBoogieWalk
This leisurely walk in the woods to banjo music is in conjunc on with the Winding Creek Bluegrass Fes val, 10 miles west of Kokomo, 100 S. 10000 W., Russiaville, IN 46936 Walkers encouraged to form teams and raise $35 each or more through sponsors and dona ons. Teams are limited to 20 walkers and there is a trophy for the top fundraising team. Register by August 3 and get a free Banjo Boogie Walk t‐shirt. Proceeds will benefit Samaritan Caregivers; providing help and hope to needy seniors. DAY OF EVENT noon—1 pm: Check in for walk & turn in addi onal money raised. No pets or strollers please—please bring photo ID. Walk course is through a wooded area on a hilly course that is not paved. Please wear suitable clothing and footwear for your safety and comfort. Banjo music is provided at numerous sites throughout the walk course. The Banjo Boogie is held in conjunc on with the Winding Creek Bluegrass Fes val, where some of America’s best bluegrass bands will be performing. For more Fes val info, www.windingcreekbluegrass.com. SupportingIndependence
WaiverofLiability
BanjoBoogieWalk
DATE: SUNDAY, AUGUST 23, 1:30 PM LOCATION: 10 miles W. of Kokomo, 100 S. 10000 W., Russiaville, IN COST: Walkers solicit dona ons from corporate or individual sponsors to meet/exceed their $35 minimum. Check out www.firstgiving.com to raise more $$$ online as a grassroots individual. Walkers are encouraged to form teams to walk together during the Banjo Boogie Walk. Teams may have up to 20 walkers & there is a trophy for the top fundraising team. Register by 8/3/2015 for a free Banjo Boogie T‐shirt. DETAILS: Return your completed registra on form, $35 minimum fee and signed waiver to Samaritan Caregivers, 2705 S. Berkley Rd., Ste. 3C, Kokomo, IN 46902 BysigningthisWaiverofLiability,Iunderstandandagreetothe
following:ThatIwillnotholdSamaritanCaregiver,Inc.responsible
foranyinjuryordamagetomypersonorpropertythatmayhappen
outofand/orrelatedto,myparticipationintheBanjoBoogieWalk,
August23,2015,whetherasavolunteer,participantorworker,in
thisevent,whethercausedbySamaritanCaregivers,Inc.orits
agents,orotherwise.Inaddition,Iwaiveandgiveupanyandall
claim(s)forinjuryordamagestomypersonorpropertythatImay
haveagainstSamaritanCaregivers,Inc.thatmayhappenarisingout
of,and/orrelatedto,myparticipationinthisevent,whethercaused
bySamaritanCaregivers,Inc.oritsagents,orotherwise.Thatthis
Waiverisenforceablefortheundersigned,hispersonalrepresentatives,heirs,andnextofkin.
IalsoagreethatifIsignthisWaiveronbehalfofanothersothat
theymayparticipateinthisevent,thatIhavethelegalauthorityto
doso.
Iknowthatwalkinginawalkisapotentiallyhazardousactivity.
IshouldnotenterandwalkunlessIammedicallyableandproperly
trained.Iagreetoabidebyanydecisionofawalkof icialrelativeto
myabilitytosafelycompletethewalk.Iassumeallrisksassociated
withwalkingthisBanjoBoogieevent,including,butnotlimitedto:
damagetomypersonorproperty,falls,contactwithotherparticipants,theeffectsoftheweather,includinghighheat&/orhumidity,
andtheconditionsofthecourse,allsuchrisksbeingknownandappreciatedbyme.Havingreadthiswaiverandknowingthesefacts
andinconsiderationofacceptingmyentry,I,ormyselfandanyone
entitledtoactonmybehalf,waiveandreleasetheWindingCreek
BluegrassFestival,RobertM.&RobinL.Auth,andallothersponsors,theirrepresentativesandsuccessorsfromallclaimsorliabilitiesofanykindarisingoutofmyparticipationinthiseventeven
thoughthatliabilitymayariseoutofnegligenceorcarelessnesson
thepartofthepersonsnamedinthiswaiver.Iunderstandthat
bicycles,skateboards,babyjoggers,rollerskatesorblades,
animals&radioheadsetsarenotallowedinthewalkandIwill
abidebythisguideline.Igrantpermissiontoalloftheforegoingto
usephotographs,videorecordingsoranyotherrecordofthisevent
foranylegitimatepurpose.
PrintName________________________________________________________________
Signature__________________________________________________________________
Parent/orGuardianifunder18________________________________________
Date_______________________
Registration
Please print legibly—one form per par cipant. Name_____________________________________ Team Name________________________________ Mailing Address_____________________________ City_______________________________________ State__________ Zip_____________ Phone_____________________________________ Email______________________________________ Register by August 3 & get a free t‐shirt. Circle size Adult: S M L XL XXL Checks payable to Samaritan Caregivers; Visa, MC, Discover, American Express also accepted. Online registra on at www.samaritancaregivers.org: Banjo Boogie Walk page. Mail or bring your completed registra on & waiver, entry fee & signed waiver to: Samaritan Caregivers, 2705 S. Berkley Rd., Ste. 3C, Kokomo, IN 46902.