2. First Name*
3. Last Name*
5. Email Address*
6. Phone Number*
8. Participant is the same as above

   1. Yes
10. Participant First Name
11. Participant Last Name
13. Hold Harmless and Photo/Media Release
15. I, the registrant/guardian, by applying to participate in the Cherry Hill Township Wellness Walks, do hereby waive, release, absolve, indemnify and agree to hold harmless Cherry Hill Township, the organizers, sponsors and supervisory of the program.*

    1. Yes
17. Additionally, I the registrant/guardian, permit Cherry Hill Township and any media outlets to use my name and/or picture*

    1. Yes
    2. No
19. Take the Mayors Wellness Campaign Pledge!
21. We invite you to take the pledge for the Mayors Wellness Campaign. The goal of the Mayor's Wellness Campaign (MWC) is to improve the health and wellness of our residents and businesses by providing nutritional advice and recreational opportunities to help our residents get in shape and enjoy all our community has to offer. By signing up, you are pledging to be healthier in 2025! The pledge has 3 main components. 1) Get Active: Exercising at least 3 times a week for 30 minutes. 2) Eat Healthier: Increase consumption of fruits and vegetables, drink more water, and limiting consumption of junk food. 3) Know My Numbers: Consult with a doctor to understand my weight, BMI, cholesterol, and blood pressure.
23. I agree to take the 2025 Mayors Wellness Campaign pledge. By agreeing to this pledge, you will now be included in Mayors Wellness Campaign emails that will help to further promote your journey to get healthy!

    1. Yes
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25. Submit

* indicates a required field