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5K Walk To Support Long Island’s Holocaust Museum and Tolerance Center

Sunday, April 23, 2017

Registration: 9:30 AM

Walk Begins: 10:30 AM

Complimentary Docent Led Museum Tours Available 11:30 AM – 1:30 PM

Walk Fundraiser

$0.00

Are you registering a team?

Are you registering a team?

if yes, Team Name

Are you walking with a team?

Are you walking with a team?

I cannot attend but will make a donation

I cannot attend but will make a donation

If yes, Team Name

T-Shirts

T-shirts will be available for any registered participant who raises over $100 prior to the event. T-shirts must be picked up individually as there will be a verification list. (Team leaders may pick t-shirts on behalf of the team if requested in advance.)

T-shirt’s are also available for purchase at $25 per shirt.

t-shirt size

My t-shirt size is:

I will support with a donation of:

Would you like to kickstart your fundraising by making a donation?

Options at $25, $50, $100, $250, $500, and other

I would like to donate another amount:

I would like to donate another amount:

Waiver *

Please acknowledge that you have read and agree to the terms and conditions of the waiver.

  • I understand that my (or my minor child’s) participation in Walk the Talk, Never Again and related activated (The Event) of HMTC may involve activities that could be hazardous, in-cluding walking or running, and I knowingly assume any and all such risks in consideration of my (or my minor child’s) participation in the event. I for myself, my heirs, and my personal representatives, hereby release, waive, discharge, and covenant not to sue HMTC, its officers, employees, sponsors, organizers, licensees, or volunteers, and the event site owner or its respective officers, employees or other legal representatives or agents, for any and all injuries or damages of any kind whatsoever, which I (or my minor child) may suffer as a result of: my and/or my minor child’s participation in HMTC’s events and/or act ivies, including but not limited to any inju-ry harm and/or loss caused by the negligence, fault or misconduct of any kind on the part of HMTC or the event-site owner; any first aid given at the event; or any publication of my and/or my minor child’s likeness, including, without limitation, claims for libel or invasion of privacy.
  • I agree that HMTC and its licensees may use any and all photographic images and video or audio recordings made during the event, including those including myself and/or my minor child.
  • I understand that HMTC may use the information I provide on this form to create an individualized web page that I may use for fundraising purposes.

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SKU: walk

Thank you to our Sponsors

Andrea and Jeff Farkas and Family

Beth and Larry Farkas and Family

Jean and Eugen Gluck

Ronald H. Roth, P.C.

Media Sponsor

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