Individual or Team Captain Name:* *(required for online registration) # of Members on your team (include family members): Organization: Address: City/State/Zip: Email:* *(required for online registration) Phone #: I would like to reserve a 2007 Power of Recovery Walk T-shirt (to be purchased at walk for $15.00 or 2 for $20, XXL & XXXL will be $20.00 each) Preferred size(s): (Available sizes: Youth S, M, L and Adult S, M, L, XL, XXL, XXXL) Please note: There are no guarantees of t-shirt availability. Shirts will be sold at the event on a first come first served basis. Proceeds from t-shirt sales will offset the costs of this FREE event. Any profit will be donated to the 24-hour Alcohol and Drug Helpline. Please add me to your mailing list to receive information about future Power of Recovery events. Waiver: By registering to walk in the 2007 Power of Recovery Walk, I hereby release Residence XII, the City of Kirkland, Carillon Point, all personnel, any co-sponsoring organziation or agency from any and all responsibility for any injuries or damages I may incur as a result of my participation in the 2007 Power of Recovery Walk. I assume all risks associated with this walk including, but not limited to, falls, traffic, conditions of the sidewalk, and weather conditions. I hereby certifiy that I am in good condition and am able to walk in this event. Additionally, I permit the use of my picture in broadcast, print, etc., without my name. I understand that additional permission will be required to use my name in any manner. Additional comments:
