FASHRM 2021 Student Scholarship Ride Registration Form

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First Name *

Last Name

Street Address

City

State

Code

Would you like to be contacted for future FASHRM community events?

Yes

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E-Mail Address

Registration Status *

Rider

Passenger

WAIVER OF RIGHTS UNDER STATE STATUTES : I agree to waive all benefits flowing from any state statue which would negate or limit the scope of this release and Indemnification Agreement. By signing this Release, I certify that I have read this Release and fully understand it and that I am not relying on any statements or representation made by the Fayetteville Area Society for Human Resource Management (FASHRM). *

Agree

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