Rock for Recovery Walk Event Wednesday, October 3, 2018*5:30pm Rock County Fairgrounds Presented by the Rock County Drug Court Program Working to promote recover and change lives The Walk will be followed by the Rock for Recovery event from 6:30-8:00pm PLEASE COMPLETE THE FOLLOWING REGISTRATION AND MAIL IT TO Rock County Drug Court Office 303 W. Court St., Janesville, WI 53548 CHECK PAYABLE TO: Rock County Treasurer's Office First Name: Last Name: Street Address: City State: Zip: I Date of Birth (mm/ddlyy) Email Of requesting regstratonconimation): Entry Fee: $10.00 1 This is an untimed event intended to raise awareness and unity the community in support ofI I alcohol and drug recovery. Walk is approximately 1.2 miles and will take about 30 mintes Please read and sign below Release and Waiver of Liability I understand that signing this Release and Waver of Liablity is a signácant act with legal consequences. I am voluntarily signing this Release and Waver of Liablty in consideration for my choice to participate in this event. I further eoxpressly agree that this Release and Waiver of Liability is intended to be as broad and nclusive as is permitted by the laws of the State of Wisconsin and that if any portion is held ivalid, it i I agreed that the balance shal, not withstanding, continue in full legal force and eflect. I further agree that I I no oral representations, statements or inducements apart from the foregoing written agreement have been I I made to me by the released parties in order to get me to sign this Release and Whiver of Liabaty Signature (oarent or guardian required if under 18) Date: I Questions? Contact Amanda Suarez (608) 247-4068 Forms available online http:lljm4c.org/programs/rock-for-recovery/