ACRS - Walk for Rice 2008

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All fields marked with * (an asterisk) must be filled out to process your registration.
ACRS does not and will not sell or share your information outside of the organization.
Thank you.
Use this registration form until June 13, 2008. After that,
please register at the event on June 16.

*First Name:

*Last Name:

*Email:

*Home Address:

Address Line 2:

*City:

*State:

*Zip:

*Phone (day):

Phone (evening):

*I will be a:

Walker Runner

*Sex:

Male Female

Age:
(for prize purposes)

Other Participants Using the above Address If entering as a team, enter Team Name: *Please enter Name, indicate Walker or Runner and Male or Female
	Name (First & Last)	Walker	Runner	Male	Female	Age (for prizes)
1
2
3
4
5
6
7
8
(To add more teammates, register again using the same team name.)

*How did you hear
about the Walk?

	Past Participant/Friend
	Church/temple/gurudwara/other place of worship
	ACRS newsletter
	Brochure
	Pick-up location/city?
	Poster
	Seen which location/city?
	Newspaper/Magazine
	Which publication?
	Radio
	Which station?
	Website
	Which one?

Yes	I am voluntarily participating in the Asian Counseling & Referral Service Walk for Rice. I release ACRS, its agents, all sponsoring and associated organizations and persons, and the City of Seattle Parks and Recreation from any and all injuries that I might incur as a result of my participation in this event.
Yes No	I understand photographs/video footage will be taken at the event and permit ACRS to use my image for its publicity materials.

Other Participants Using the above Address