Statement of Consent
I understand the risks involved in participating in the Community Christian Service Agency (CCSA) Hunger Walk and willingly and voluntarily accept these risks. I attest that I am physically fit and prepared for this event.
I grant permission for the organization to use photographs/images and quotations from me in accounts and promotions of this event.
Name of Walker (PRINT) ___________________________________Date __________________
If walker is under 18, parent or guardian signature is required here.
The information below will be used only to contact you about future CCSA events.
Are you willing to receive the CCSA newsletter by e-mail? _____ Yes _____No