Form Center

2. Last Name*
3. First Name*
5. Email*
7. Hold Harmless and Photo/Media Release
9. 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
11. Additionally, I the registrant/guardian, permit Cherry Hill Township and any media outlets to use my name and/or picture. *

    1. Yes
    2. No
Leave This Blank:


13. 1. Receive an email copy of this form.
14. Email address

    This field is not part of the form submission.

15. Submit

* indicates a required field