Name *
Lee Lott Power of Pink Walk Waiver *
I, individually, (and/or guardian of the named minor) for and in consideration of acceptance of this entry in this event, do forever waive any and all claims for myself and my heirs against officials and sponsors of the Lee Lott Power of Pink 1 Mile Walk for illness or injury which may result directly or indirectly from my participation. I further state that I am in proper physical condition to participate in this event. I also agree that if the event is cancelled for any reason that all entry fees are non-refundable.
Date *