National Conference Registration

National Conference Registration Form

Step 1 of 14

Attendee 1
Child's/Grandchild's/Sibling's Name 1
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Child's/Grandchild's/Sibling's Name 2
First Last
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Child's/Grandchild's/Sibling's Name 3
First Last
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Child's/Grandchild's/Sibling's Name 4
First Last
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Child's/Grandchild's/Sibling's Name 5
First Last
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death

Attendee 1
Add Friday Lunch ($39) for Attendee 1?
Add Saturday Dinner ($59) for Attendee 1?
Add Friday Night Sibling Event, "Denim and Diamonds," ($30) for Attendee 1?
for siblings 16+
Any Dietary Restrictions?
Please describe.
Add Walk to Remember Registration ($25) for Attendee 1?
Walk to Remember Shirt Size
Liability Waiver
In consideration of being accepted as a participant in the TCF Inc., Walk to Remember, I hereby affirm, acknowledge, and agree to the following: (1) That I assume all responsibility for any and all damages to, or theft of, my personal property or any bodily injury (including death) that may occur to me, and further, I assume responsibility for property damage and bodily injury (including death) that I may cause to others, in each case arising or resulting from, incidental to, or as a consequence of, my participation in the TCF, Inc., Walk to Remember; (2) That I, for myself, my heirs, my executors and administrators, release and hold harmless from and waive all claims, damages, and rights of action, present or future, whether the same be known or unknown, anticipated or unanticipated, foreseen or unforeseen, arising or resulting from, incident to or as a consequence of, my participation in the TCF Inc., Walk to Remember, which I may now or hereafter have against The Compassionate Friends, Inc., any business or companies along the route and any and all sponsors and volunteers for said event, and the respective directors, employees, and agents of all of the foregoing; (3) That I grant the permission for use of my name and/or picture in any broadcast, photograph, video, or other account of The Compassionate Friends, Inc., Walk to Remember; and (4) That I am aware of the physical demands and hazards of participating in a two-mile walking event such as The Compassionate Friends, Inc., Walk to Remember.
Signature (If under 18, parent or guardian signature)
If using mouse, please hold down button and sign the field.
Add Additional Attendee?*

Attendee 2
Is Child's/Grandchild's/Sibling's Name 1 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 1
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 2 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 2
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 3 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 3
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 4 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 4
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 5 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 5
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death

Add Friday Lunch ($39) for Attendee 2?
Add Saturday Dinner ($59) for Attendee 2?
Add Friday Night Sibling Event, "Denim and Diamonds," ($30) for Attendee 2?
for siblings 16+
Any Dietary Restrictions?
Please describe.
Add Walk to Remember Registration ($25) for Attendee 2?
Walk to Remember Shirt Size
Liability Waiver
In consideration of being accepted as a participant in the TCF Inc., Walk to Remember, I hereby affirm, acknowledge, and agree to the following: (1) That I assume all responsibility for any and all damages to, or theft of, my personal property or any bodily injury (including death) that may occur to me, and further, I assume responsibility for property damage and bodily injury (including death) that I may cause to others, in each case arising or resulting from, incidental to, or as a consequence of, my participation in the TCF, Inc., Walk to Remember; (2) That I, for myself, my heirs, my executors and administrators, release and hold harmless from and waive all claims, damages, and rights of action, present or future, whether the same be known or unknown, anticipated or unanticipated, foreseen or unforeseen, arising or resulting from, incident to or as a consequence of, my participation in the TCF Inc., Walk to Remember, which I may now or hereafter have against The Compassionate Friends, Inc., any business or companies along the route and any and all sponsors and volunteers for said event, and the respective directors, employees, and agents of all of the foregoing; (3) That I grant the permission for use of my name and/or picture in any broadcast, photograph, video, or other account of The Compassionate Friends, Inc., Walk to Remember; and (4) That I am aware of the physical demands and hazards of participating in a two-mile walking event such as The Compassionate Friends, Inc., Walk to Remember.
Signature (If under 18, parent or guardian signature)
If using mouse, please hold down button and sign the field.
Add Additional Attendee?*

Attendee 3
Is Child's/Grandchild's/Sibling's Name 1 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 1
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 2 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 2
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 3 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 3
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 4 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 4
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death

Add Friday Lunch ($39) for Attendee 3?
Add Saturday Dinner ($59) for Attendee 3?
Add Friday Night Sibling Event, "Denim and Diamonds," ($30) for Attendee 3?
for siblings 16+
Any dietary restrictions?
Please describe.
Add Walk to Remember Registration ($25) for Attendee 3?
Walk to Remember Shirt Size
Liability Waiver
In consideration of being accepted as a participant in the TCF Inc., Walk to Remember, I hereby affirm, acknowledge, and agree to the following: (1) That I assume all responsibility for any and all damages to, or theft of, my personal property or any bodily injury (including death) that may occur to me, and further, I assume responsibility for property damage and bodily injury (including death) that I may cause to others, in each case arising or resulting from, incidental to, or as a consequence of, my participation in the TCF, Inc., Walk to Remember; (2) That I, for myself, my heirs, my executors and administrators, release and hold harmless from and waive all claims, damages, and rights of action, present or future, whether the same be known or unknown, anticipated or unanticipated, foreseen or unforeseen, arising or resulting from, incident to or as a consequence of, my participation in the TCF Inc., Walk to Remember, which I may now or hereafter have against The Compassionate Friends, Inc., any business or companies along the route and any and all sponsors and volunteers for said event, and the respective directors, employees, and agents of all of the foregoing; (3) That I grant the permission for use of my name and/or picture in any broadcast, photograph, video, or other account of The Compassionate Friends, Inc., Walk to Remember; and (4) That I am aware of the physical demands and hazards of participating in a two-mile walking event such as The Compassionate Friends, Inc., Walk to Remember.
Signature (If under 18, parent or guardian signature)
If using mouse, please hold down button and sign the field.
Add Additional Attendee?*

Attendee 4
Is Child's/Grandchild's/Sibling's Name 1 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 1
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death
Add additional Child's/Grandchild's/Sibling's Name
Is Child's/Grandchild's/Sibling's Name 2 the same as Attendee 1?
Child's/Grandchild's/Sibling's Name 2
First Name Last Name
Child's/Grandchild's/Sibling's Name to be listed on name badge
Relationship to Attendee
Relationship?
Date of Birth
Date of Death
Cause of Death

Attendee 4
Add Friday Lunch ($39) for Attendee 4?
Add Saturday Dinner ($59) for Attendee 4?
Add Friday Night Sibling Event, "Denim and Diamonds," ($30) for Attendee 4?
for siblings 16+
Add dietary restrictions?
Please describe.
Add Walk to Remember Registration ($25) for Attendee 4?
Walk to Remember Shirt Size
Liability Waiver
In consideration of being accepted as a participant in the TCF Inc., Walk to Remember, I hereby affirm, acknowledge, and agree to the following: (1) That I assume all responsibility for any and all damages to, or theft of, my personal property or any bodily injury (including death) that may occur to me, and further, I assume responsibility for property damage and bodily injury (including death) that I may cause to others, in each case arising or resulting from, incidental to, or as a consequence of, my participation in the TCF, Inc., Walk to Remember; (2) That I, for myself, my heirs, my executors and administrators, release and hold harmless from and waive all claims, damages, and rights of action, present or future, whether the same be known or unknown, anticipated or unanticipated, foreseen or unforeseen, arising or resulting from, incident to or as a consequence of, my participation in the TCF Inc., Walk to Remember, which I may now or hereafter have against The Compassionate Friends, Inc., any business or companies along the route and any and all sponsors and volunteers for said event, and the respective directors, employees, and agents of all of the foregoing; (3) That I grant the permission for use of my name and/or picture in any broadcast, photograph, video, or other account of The Compassionate Friends, Inc., Walk to Remember; and (4) That I am aware of the physical demands and hazards of participating in a two-mile walking event such as The Compassionate Friends, Inc., Walk to Remember.
Signature (If under 18, parent or guardian signature)
If using mouse, please hold down button and sign the field.

Total
$0.00
Coupon
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address
Street Address City State / Province / Region ZIP / Postal Code Country
Billing Phone Number
Name
This field is for validation purposes and should be left unchanged.

Close [x]

National Conference Registration

Step 1 of 14

Attendee 1

Attendee 1

Attendee 1

Liability Waiver

Attendee 2

Attendee 2

Liability Waiver

Attendee 3

Attendee 3

Liability Waiver

Attendee 4

Attendee 4

Attendee 4

Liability Waiver

Sponsorships

Find a Local Chapter

Find Support

About

How You Can Help

Menu

Social

© 2017 The Compassionate Friends. Privacy Policy
This site was donated by the Open to Hope Foundation in loving memory of Scott Preston Horsley.

Non Profit Web Design by Idea Marketing Group

Close [x]

National Conference Registration

Step 1 of 14

Attendee 1

Attendee 1

Attendee 1

Liability Waiver

Attendee 2

Attendee 2

Liability Waiver

Attendee 3

Attendee 3

Liability Waiver

Attendee 4

Attendee 4

Attendee 4

Liability Waiver

Sponsorships

Find a Local Chapter

Sign Up for the Compassionate Friends Newsletter

Find Support

About

How You Can Help

Menu

Social

© 2017 The Compassionate Friends. Privacy PolicyThis site was donated by the Open to Hope Foundation in loving memory of Scott Preston Horsley.

Non Profit Web Design by Idea Marketing Group

© 2017 The Compassionate Friends. Privacy Policy
This site was donated by the Open to Hope Foundation in loving memory of Scott Preston Horsley.