2022 Living Water of Love Walkathon
All walkers must sign up here and if you want to join the tour, you need to rsvp again under another form.
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Email *
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Your Full Name 你的姓名: *
Please Choose Contact Devices 所用的溝通媒體: *
Required
Cell Phone 手提電話: *
Email 電郵: *
Age Group 年齡群 *
Full Address 地址: *
Gender 性別 *
How do you know the event? 你如何得知是次活動? *
Check Your Option of Fundraising 參加籌款活動: *
Required
Check Your Choice of Fundraising Pledge: 你選擇籌款的方式 *
Required
Fundraising Goals Amount籌款目標 $:
Person to Notify in Case of Emergency Name / Phone / Email:                                                                                            緊急聯絡人的姓名 / 電話 /  電郵 *
Living Water Counselling Centre - Release Waiver And Indemnity  免責聲明
I, on behalf of myself, my heirs, administers, successors and assigns hereby waive all claims against Living Water Counselling Centre, its directors, staffs, volunteers and sponsors, the City of Toronto and my local church and agency, for any injury I might suffer in this event. I attest that I am physically fit and prepared for this event.  
 本人代表自己、本人的繼承人、執行人、繼任及授權人,豁免對泉湧輔導中心,董事、同工、義工、贊助者、大多倫多市教會或機構為本人於此項活動中有任何可能受傷的追究。本人聲明自己健康狀況良好,適合參加此項活動                                                        
Participant’s Signature OR Parent/Legal Guardian Signature (if under 18),  Full Name (type)   參加者簽名或父母/法定監護人簽名(如未滿18歲) 填寫全名:  *
Multimedia Consent, Waiver, Indemnity and Release   媒體肖像豁免聲明
I  consent to be taken photographs, videotapes, film, motion picture or record of my participation to be made available on webpage or their respective social media sites.
I agree that I shall have no claim against Living Water Counselling
Centre or against anyone accessing these images, whether online, in print or by any other means.
This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.

本人授權與泉源輔導中心在此項活動中拍照,攝像及錄影。並許可泉源輔導中心處理以及發放在其網站及媒體報導。本人不會向泉源輔導中心索取任何有關報酬,並同意泉源輔導中心全權使用的權利。本人代表自己,本人的繼承人,執行人,繼任人及授權人做出以上和豁免聲明。
Participant’s Signature OR Parent/Legal Guardian Signature (if under 18),  Full Name (type)   參加者簽名或父母/法定監護人簽名(如未滿18歲) 填寫全名: 
*
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