Jacob's Joy Walk by Faith Registration & Order Form
Please complete this form to register for the walk
You can also use this form to order your personalized OR awareness items
T-Shirts $25 (XXL+$2 XXXL+$3) shipping is $5
Car Window Decals $5 (shipping is $3)
Single Sided Sign $20 (shipping unavailable)
Double Sided Sign $30 (shipping unavailable)
Bracelet $1 (shipping is $3)
*shipping may be combined when ordering multiple items
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Your Name *
Email *
Please list names of all those who will be attending the remembrance walk in person as well as the ages of any children (under 18) *If you are not attending in person, please put NA *
Please sign your name below to agree to the following: In consideration of you accepting this entry, I, the participant, intending to be legally bound do hereby waive and forever release any and all right and claims for damages or injuries that I may have against the Event Director, Jacob's Joy, Camp Sabroske, Carrol Township, all agents assisting with the event, sponsors and their representatives, volunteers and employees for any and all injuries to me or my personal property. This release includes all injuries, illnesses and/or damages suffered by me before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.  Walkers who intend to participate in the actual race must attest that on WALK DAY they are healthy, with no symptoms of: fever or temperature greater than 100.0 degrees, cough, respiratory symptoms, diarrhea, nausea, loss of taste or smell and that they have not been exposed to anyone diagnosed with COVID-19 in the past 14 days prior to the event. The aforementioned will not be held responsible should you contract COVID-19 after attending this event. We thank you for your support and understanding.  I assume all risks associated with participating in this event including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and course conditions, and waive any and all claims which I might have based on any of those and other risks typical found in walking on an unpaved path. I acknowledge all such risks are known and understood by me. I agree to abide by all decisions of any Jacob's Joy official relative to my ability to safely complete the walk.  In the event of an illness, injury or medical emergency arising during the event I hereby authorize and give my consent to the Event Director to secure from any accredited hospital, clinic and/ or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment and hospitalization. By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above release and waiver. Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, videographic or electronic recording of this event for legitimate purposes. *
Prior to the walk, we will have a ceremony which will include a reading of the names of all the babies we are honoring.  Please list your babies name(s) if you would like to include them in the ceremony.
How would you like to get your items
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If you need your items shipped, please include your address *Shipping cost is $5 (total) for shirts and $3 (total) for window decals and/or bracelets- if ordering with shirt(s)  shipping is $5 total.  **We cannot ship yard signs
T-Shirt Preview ($25 (XXL+$2 XXXL+$3)
Baby(ies) name(s) to include on the back of the shirt
Shirt size & Quantity
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2
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4
XL
6
7
8
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10
XS
S
M
L
XL
XXL (+$2)
XXXL (+3)
Youth XS
Youth S
Youth M
Youth L
Youth XL
Car Window Decal Preview ($5)
Decal Options
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2
3
4
5
Personalized
Awareness
Please indicate how you would like to personalized your decal
Yard Sign Preview (Single Sided $20 Double Sided $30)
Yard Sign Options
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2
3
4
5
Single Sided
Double Sided
Please indicate how you would like to personalized your yard sign
Awareness & Support Bracelet Preview ($1)
Pregnancy & Infant Loss Awareness Bracelet
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3
4
5
6
7
8
9
10
Child Size
Adult Size
How would you like to pay for your items? *Invoice and instructions for payments will be sent via Email **Must be paid for by Thursday, October 14th (unless paying by check)
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