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Individual/Team Registration

Registration for the Lions 5k Walk is FREE! To register, simply fill in the form below and click submit.

If optionally you would like to make a donation after registering, visit our donations page for more information.

* Indicates A Required Field Or Section


* First Name:  

* Last Name:  

Age on Walk Day (Oct. 4, 2009):  
* Gender:   Male   Female  

Contact Information

Address


* Street Address:

Apt:      * City:  

* Postal Code (no spaces):

Telephone Number (no symbols or spaces)


* Home: - -

Work: - - Ext:

* Email:



* Registration Type Individual

Team

Join a team      Create a new team

Team Name:

* Waiver

This waiver must be read, signed and submitted at registration before the walk.

In consideration of the acceptance of the participant's (volunteer and/or walker) application and the permission to participate as an entrant in the LIONS 5K Walk on Sunday, October 4, 2009 the participant (volunteer and/or walker) and, if the participant (volunteer and/or walker) is under the age of majority, the parent or guardian of the participant (volunteer and/or walker) personally and as parent or guardian on behalf of the participant (volunteer and/or walker) for myself/ourselves, my/our heirs, executors, administrators, successors and assigns hereby release, waive and forever discharge Lions International, Milliken Mills Lions Club and Social Services Network for the York Region, the Town of Markham park and municipal authorities, the police force, the transit authorities, the organizing committee(s), and all other associations, sanctioning bodies and sponsoring companies, all their respective agents, officials, servants, contractors, representatives, elected and appointed officials, successors and assigns of and from all claims, demands, damages, costs, expenses, actions and causes of action, whether in law or in equity, in respect of death, injury, loss or damage to my/our person or property howsoever caused, including without limitation claims pursuant to the Occupiers' Liability Act of Ontario, arising or to arise by reason of my/our participation in the said event, whether as spectator, participant, competitor or otherwise; whether prior to, during or subsequent to the event and notwithstanding that same may have been contributed to or occasioned by the negligence of any of the aforesaid.

I/we know that participating in physical fitness events is a potentially hazardous activity. I agree not to participate unless I am medically able and properly prepared. I should not participate without my physician's approval.

I/we further hereby undertake to hold and save harmless and agree to indemnify all of the aforesaid from and against any and all liability incurred by any or all of them arising as a result of, or in any way connected with my/our participation in the said event. By submitting this entry, I/we acknowledge having read, understood and agreed to the above waiver, release and indemnity. I/we warrant that the participant (volunteer and/or walker) is physically fit to participate in this event.

I/We hereby authorize Milliken Mills Lions Club and Social Services Network for the York Region to record my/our picture and voice on photographs, films and tapes and to incorporate these recordings into any video, photograph, publication or any other material and to use and license others to use such recordings and images in any manner of media whatsoever, including unrestricted use of my/our name, voice, and biographic information in connection therewith.


By submitting this entry, you acknowledge having read, understood and agreed to the above waiver, release and indemnity