Empower Others

Volunteer for the Cure

(*) - Required
First Name (*)
Last Name (*)
Address
City
State
Zip
Home Phone
Cell Phone
Work Phone
E-mail (*)
Date of Birth
Sex
Shirt Size
Areas of Interest
Komen Atlanta Race for the Cure Education and Community Outreach Programs Special Events Affiliate Administration - Office Projects Tennis for the Cure Survivor Events
Comments - (maximum 500 characters)

Please check I assume all risks associated with my participation as a volunteer for the event(s) I have indicated on this form including but not limited to injuries, contact with other participants including registered participants and other volunteers, all such risks are known and appreciated to me. Having read this waiver I, for myself and anyone entitled to act on my behalf, wave and release Susan G. Komen for the Cure Greater Atlanta Affiliate, its employees and volunteers, all city and county governments and all sponsors, their representative and successors from all claims or liabilities of any kind arising out of my participation in the (these) event(s). I grant permission to all of the foregoing to use any photographs, motion pictures, recording or any other record of the (these) events(s) for any legitimate purpose.