2008 Steps for Seizures Registration Form Please note:  All registration forms must be received prior to October 21st to receive T-shirt for the event.  You may register the day of the event by going to the registration table and you will receive a T-shirt from last year's walk (limited quantities). If you are registering as a family, a separate form must be filled out for each person walking.  Please note: a family registration consists of two adults and up to 3 children.   If you have more than 3 children, then there is an additional fee of $5.00 per child.   Remember to visit our pledge form page to print out and take to family, friends and coworkers to raise additional funds.  There will be prizes awarded the day of the walk for the 2 highest pledge donation totals. First Name_______________Last Name________________________ Address_________________________________________________ Email____________________________ Age on Day of Run___________Sex__________ $15.00 per person  -  Families@$40.00 per Family (up to 5) $5.00 for each add'l Total Paid        ________________ Specify T-shirt size Adult(S)_____(M)_____(L)_____(XL)_____ Child(S)_____(M)_____(L)_____ Waiver:  The above individuals will not hold Clayton's Hope Organization, Steps for Seizures, Washington Lake Park, sponsors or any volunteers liable for lost items or injuries incurred during Steps for Seizures. _______________________________________________________________ Signature of participant or guardian if under age 18 Please make checks payable and mail to: Clayton's Hope 144 Johnson Road Turnersville, NJ  08012

Registration Form