OLHSA

Tickets
Guests
Confirmation

Oakland Livingston Human Service Agency Logo

Register to Walk

Livingston Walk

Hartland Educational Support Service Center - 9525 E Highland Rd.
Howell, MI 48843

Saturday, February 11, 2023

8:30 - 11:00 AM

Use this form to register your immediate family members and those for whom you are legally allowed to sign a waiver.

Adult Registration

Complimentary

Child Registration (17 and under)

Complimentary

Choose a shirt size for each of the members of your family that you are registering on this form:

Youth Small

$25

Youth Medium

$25

Adult Small

$25

Adult Medium

$25

Adult Large

$25

Adult XL

$25

Adult 2XL

$25

Adult 3XL

$25

Adult 4XL

$25

Consider adding a donation

Your support will be attributed to:

Livingston Dems

I'd like to sign up! If you choose this option, you will be taken to customize your page.

Apply funds to myself If you choose this option, you will be taken to customize your page, and your total will be applied there.

You can make an even BIGGER difference for the people in our community by signing up to become a fundraiser and fundraising in the weeks leading up to the walk!

Above, select "I'd like to sign up!" and you can create and personalize your own fundraising page.

Contact information

First Name

Last Name

Please don't list my name on the walk website

Mobile Number

Address

City

State

Zip

Participation Waiver

I fully recognize that certain risks are involved while volunteering/ participating in the Oakland Livingston Human Service Agency (OLHSA) Walk for Warmth (“program”) on Saturday, February 11, 2023 and/or Saturday, May 6, 2023 and I voluntarily assume these risks.

Such risks may include, but not be limited to loss of my property or physical injury to me (or my child) up to and including death from negligent or intentional actions. I agree that if I (or my child) incur any such loss of property or injury, including death, neither I nor my family members, nor my estate or heirs will hold Hartland Educational Support Service Centers (HESSC) / Canterbury Village or any of their respective employees or agents responsible or seek damages from any of these entities in any form unless they have acted in a grossly negligent manner or committed an intentional tort. I further understand that none of these businesses or people carries liability insurance or hospital or medical protection for these purposes.

During the course of the program’s activities, I will conduct myself in a prudent and cautious manner and during the time that I am involved in the program, I will treat Hartland Educational Support Service Centers (HESSC) / Canterbury Village and all other persons using HESSC / Canterbury Village premises in a lawful manner.

I attest to all of the above that has been written. By signing this waiver, I certify that I have read and understand the above statement and that my signing this waiver is completely voluntary.

I have read and agreed to the terms of the above waiver

Payment information

This is a secure 256-bit SSL encrypted payment

Card Number

Expiration Date

CVV

I would like to cover the payment processing fee.

Donor hereby approves the payment of the charitable donation and/or purchase to Oakland Livingston Human Service Agency and in the amount set forth herein.

Consider adding a donation

Contact information

Participation Waiver

Payment information

Total Amount