Sign up for the 12th Annual Joe Chaves Memorial 5K Walk

Date: Sunday, October 1, 2023 at 1:00pm

Salutation | Saudação

Mr. | Sr.

Mrs. | Sra.

Ms.

Name | Nome

First Name

Last Name

Organization | Organização

Email

Phone | Telefone

(###)

###

####

Twitter account

@

Address | Endereço

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would like to:

Number of Participants | Numero de Participantes

Team Name | Nome do Grupo

I pledge to donate | doação

$

As a participant in the Joe Chaves 5K Walk-a-thon, I will assume all risks of personal injury, death, or property loss that occurs as a participant. I certify that I am physically capable of participating in this event and am 18 years of age or older, or I am the legal guardian of the child(ren) attending this event. I grant full permission to the event organizers to use and publish my name and image as a participant in all media.

I agree

DONATIONS

Donations may be made in the form of a CHECK payable to “Joe & Dorothy Chaves Foundation”.

Checks can be received at the event or, if you wish to mail your contribution, you may send it to:

Joe & Dorothy Chaves Foundation
51 Webster Street
Arlington, MA 02474

DISCLAIMER

All participants are required to sign a waver prior to, or at, the event.