Student Registration

DATE:
September 29, 2024

TIME:
2:00pm - 4:00pm

LOCATION:
Richmond Green Park
1300 Elgin Mills Rd E, Richmond Hill, ON L4S 1M5

Student Registration Form

First name

Last name

Email

Phone

School that you are attending

Emergency Contact Name

Emergency Contact Number

Waiver: I waive all rights of claims that I may have against One Heart Beat March, walk officials, administrators, or any other organizations or individuals associated with this event. I attest and verify that I am physically fit for participation in this event.

I give permission to have myself appeared in any public or media coverage, including but not limited to photographs, videotapes, recordings as approved by One Heart Beat March.

Parent Signature (NOTE: If the registant is under the age of 18, a parent or legal guardian must sign below)

ONE HEART BEAT MARCH 2024ONE HEART BEAT MARCH 2024