Online Registrations must be completed by April 20th, 2010
Team Name:
My Name:
Name (under 18):
Address Line 1:
Address Line 2:
Telephone:
Email:
Additional Info (If you have more then 5 team members please use this area to list):
By submitting this form or by participating in the event, I (we) herby waive and release any and all rights and claims for damages that I (we) may heave against you, the location where the event will take place, as well as any person connected with Upstate NY Autism Awareness, their heirs, executors and successors for any and all injuires that I or anyone on my team may suffer while taking part in the event. I understant I am signing for myself as well as all family and team members.
