SlideShare a Scribd company logo
Walk to Stop
                                  Underage Drinking & Drugs
                                                                                                    REGISTRATION FORM
                                                                     Individuals & Families Welcome!
Help Save Lives! Join our                                             Well Paved Stroller-Friendly Path!
                                                                              Pet’s On A Leash Welcome!
prevention efforts!                                             REGISTRATION FEES:
DATE AND TIME:                                                  Ages 18 & Up $20 / Ages 6-17 $10
Saturday, October 16, 2010                                      Registration forms should be submitted by October
Registration starts at 7:30AM                                   13, 2010, accompanied by a check and mailed to:
2 Mile walk begins at 8:30AM                                            Amistades, Inc.
1 Mile walk begins at 9:00AM                                            680 W. Prince Road, Suite 110
                                                                        Tucson, AZ 85705
LOCATION AND DIRECTIONS:
                                             Rillito River Park Please make checks payable to Amistades, Inc.
                                             Path               Onsite registration will be available; pre-registration
                                                                is encouraged. Cash & checks will be accepted on
                                             COURSE:            site.
                                             Maps of 1 mile
                                             and 2 mile         ABOUT AMISTADES, INC:
                                             walking paths on Amistades, Inc. is a non-profit 501 (c) (3) community
                                             back.              development and substance abuse prevention
                                                                organization. The mission of Amistades is to provide
                                                                culturally competent prevention services to reduce
                                                                the use of alcohol, tobacco, and other substance
                                                                abuse problems affecting Latino youth and families.

  REGISTRATION FORM:                                                               I certify to the best of my knowledge that I am physically fit
First Name:                       Last Name:                                       and have no medical condition that could likely worsen by
                                                                                   participating in this event. I am fully aware and assume all
Email:                                                                             risks associated with participating in this event. I under-
                                                                                   stand that the walk is in a public area and that participation
Street Address:                                                                    could be hazardous. In consideration for accepting my
                                                                                   entry, I the undersigned, intending to be legally bound
City:                     State:         Zip:                                      hereby for myself, my heirs, my executors, and administra-
Daytime Phone:                   Evening Phone:                                    tors, contractually waive and release any and all rights and
                                                                                   claims for the damages I may suffer or which may arise
Age as of 10/16/10:              Total Registration $:                             against Amistades, Inc. and any sponsor of this event for
                                                                                   any and all injuries occurring by reason of the negligent
I plan to participate in:                                                          acts or omissions of Amistades, Inc., sponsors or otherwise
                                                                                   from claims and damages suffered by me or to by property
    1 Mile Walk                                                                    arising out of connection with this event. I also grant full
                                                                                   permission to Amistades, Inc. and sponsors to use photo-
    2 Mile Walk                                                                    graphs, motion pictures, videotapes, recordings, or any
Signature:                                     Date:                               other record of this event for any legitimate purpose. My
                                                                                   signature verifies that I have read and agree to the terms
Co-Signature:                                   Date:                              stated above. I understand that unsigned entries will not
(if under 18 years of age, a parent or guardian must sign)                         be accepted.

            “The Flowing Wells School District neither endorses nor sponsors the organization or activity represented in this
                          document. The distribution of this material is provided as a community service.”
QUESTIONS: Please send email inquiries to claudiajassostevens@amistadesinc.org or call Joe at 520-955-3907.

More Related Content

Viewers also liked

Power point chapter 17
Power point chapter 17Power point chapter 17
Power point chapter 17
mcnewbold
 
Volcanoes and Earthquakes
Volcanoes and EarthquakesVolcanoes and Earthquakes
Volcanoes and Earthquakes
AnabelSMartin27
 

Viewers also liked (20)

Ap Probe Finds Drugs In Drinking Water
Ap Probe Finds Drugs In Drinking WaterAp Probe Finds Drugs In Drinking Water
Ap Probe Finds Drugs In Drinking Water
 
Women’s access to justice and land and property rights in Cambodia
Women’s access to justice and land and property rights in Cambodia Women’s access to justice and land and property rights in Cambodia
Women’s access to justice and land and property rights in Cambodia
 
Bio polymer enterprises inc.
Bio polymer enterprises inc.Bio polymer enterprises inc.
Bio polymer enterprises inc.
 
Volcano mini poster
Volcano mini posterVolcano mini poster
Volcano mini poster
 
Natural disasters
Natural disastersNatural disasters
Natural disasters
 
Slides for optical isomerism
Slides for optical isomerismSlides for optical isomerism
Slides for optical isomerism
 
Enantiomers
EnantiomersEnantiomers
Enantiomers
 
The War on Cancer Requires Powerful Weapons
The War on Cancer Requires Powerful WeaponsThe War on Cancer Requires Powerful Weapons
The War on Cancer Requires Powerful Weapons
 
Microchip electrophoresis
Microchip electrophoresisMicrochip electrophoresis
Microchip electrophoresis
 
Radioactive Waste Management
Radioactive Waste ManagementRadioactive Waste Management
Radioactive Waste Management
 
Optical isomerism
Optical isomerismOptical isomerism
Optical isomerism
 
Charles Akhideno Health, Safety & Environment Lead at Shell Nigeria -Challeng...
Charles Akhideno Health, Safety & Environment Lead at Shell Nigeria -Challeng...Charles Akhideno Health, Safety & Environment Lead at Shell Nigeria -Challeng...
Charles Akhideno Health, Safety & Environment Lead at Shell Nigeria -Challeng...
 
Isomers
IsomersIsomers
Isomers
 
Radioactive waste management
Radioactive waste managementRadioactive waste management
Radioactive waste management
 
B sc i chemistry i u iii(b) molecular formula and empirical formula a
B sc  i chemistry i u iii(b)  molecular formula and empirical formula aB sc  i chemistry i u iii(b)  molecular formula and empirical formula a
B sc i chemistry i u iii(b) molecular formula and empirical formula a
 
Power point chapter 17
Power point chapter 17Power point chapter 17
Power point chapter 17
 
World Environment Day Powerpoint (2)
World Environment Day Powerpoint (2)World Environment Day Powerpoint (2)
World Environment Day Powerpoint (2)
 
Chemical equilibrium
Chemical equilibrium Chemical equilibrium
Chemical equilibrium
 
Volcanoes and Earthquakes
Volcanoes and EarthquakesVolcanoes and Earthquakes
Volcanoes and Earthquakes
 
High performance liquid chromatography
High performance liquid chromatographyHigh performance liquid chromatography
High performance liquid chromatography
 

More from Jasso Development & Planning

Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration 2010
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration  2010Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration  2010
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration 2010
Jasso Development & Planning
 
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...
Jasso Development & Planning
 

More from Jasso Development & Planning (19)

Tributo a La Mujer Hispana
Tributo a La Mujer HispanaTributo a La Mujer Hispana
Tributo a La Mujer Hispana
 
Yoga en Español at the YOGA Connection
Yoga en Español at the YOGA ConnectionYoga en Español at the YOGA Connection
Yoga en Español at the YOGA Connection
 
Segundo de Febrero Commemoration Program 2011
Segundo de Febrero Commemoration Program 2011Segundo de Febrero Commemoration Program 2011
Segundo de Febrero Commemoration Program 2011
 
Save th
Save thSave th
Save th
 
Amistades, Inc. Press Release December 2010
Amistades, Inc. Press Release December 2010Amistades, Inc. Press Release December 2010
Amistades, Inc. Press Release December 2010
 
Claudia Jasso-Stevens, Amistades, Inc. Treaty Project and Commemorative Dinne...
Claudia Jasso-Stevens, Amistades, Inc. Treaty Project and Commemorative Dinne...Claudia Jasso-Stevens, Amistades, Inc. Treaty Project and Commemorative Dinne...
Claudia Jasso-Stevens, Amistades, Inc. Treaty Project and Commemorative Dinne...
 
Claudia Jasso-Stevens, Amistades Walk To Stop Underage Drinking & Drugs
Claudia Jasso-Stevens, Amistades Walk To Stop Underage Drinking & DrugsClaudia Jasso-Stevens, Amistades Walk To Stop Underage Drinking & Drugs
Claudia Jasso-Stevens, Amistades Walk To Stop Underage Drinking & Drugs
 
Claudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--Arizona
Claudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--ArizonaClaudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--Arizona
Claudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--Arizona
 
Claudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--Arizona
Claudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--ArizonaClaudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--Arizona
Claudia Jasso-Stevens, 40 Hispanic Leaders Under 40 Awards--Arizona
 
Claudia Jasso-Stevens and Congressman Grijalva
Claudia Jasso-Stevens and Congressman GrijalvaClaudia Jasso-Stevens and Congressman Grijalva
Claudia Jasso-Stevens and Congressman Grijalva
 
Claudia Jasso-Stevens at the Roman Catholic Diocese
Claudia Jasso-Stevens at the Roman Catholic DioceseClaudia Jasso-Stevens at the Roman Catholic Diocese
Claudia Jasso-Stevens at the Roman Catholic Diocese
 
Claudia Jasso-Stevens and Sean Arce
Claudia Jasso-Stevens and Sean ArceClaudia Jasso-Stevens and Sean Arce
Claudia Jasso-Stevens and Sean Arce
 
Claudia Jasso-Stevens and Project Partners
Claudia Jasso-Stevens and Project PartnersClaudia Jasso-Stevens and Project Partners
Claudia Jasso-Stevens and Project Partners
 
Claudia Jasso-Stevens and Project Partners
Claudia Jasso-Stevens and Project PartnersClaudia Jasso-Stevens and Project Partners
Claudia Jasso-Stevens and Project Partners
 
Claudia Jasso-Stevens and Planning Committee
Claudia Jasso-Stevens and Planning CommitteeClaudia Jasso-Stevens and Planning Committee
Claudia Jasso-Stevens and Planning Committee
 
Claudia Jasso-Stevens News Release 4th Annual 40 Hispanic Leaders Under 40...
Claudia Jasso-Stevens  News Release   4th Annual 40 Hispanic Leaders Under 40...Claudia Jasso-Stevens  News Release   4th Annual 40 Hispanic Leaders Under 40...
Claudia Jasso-Stevens News Release 4th Annual 40 Hispanic Leaders Under 40...
 
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration 2010
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration  2010Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration  2010
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration 2010
 
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...
Claudia Jasso-Stevens, Amistades, Inc. Segundo de Febrero Commemoration Invit...
 
Amistades Treaty of Guadalupe Hidalgo 1848 Project
Amistades Treaty of Guadalupe Hidalgo 1848 ProjectAmistades Treaty of Guadalupe Hidalgo 1848 Project
Amistades Treaty of Guadalupe Hidalgo 1848 Project
 

Recently uploaded

Additional Benefits for Employee Website.pdf
Additional Benefits for Employee Website.pdfAdditional Benefits for Employee Website.pdf
Additional Benefits for Employee Website.pdf
joachimlavalley1
 

Recently uploaded (20)

Danh sách HSG Bộ môn cấp trường - Cấp THPT.pdf
Danh sách HSG Bộ môn cấp trường - Cấp THPT.pdfDanh sách HSG Bộ môn cấp trường - Cấp THPT.pdf
Danh sách HSG Bộ môn cấp trường - Cấp THPT.pdf
 
How to Break the cycle of negative Thoughts
How to Break the cycle of negative ThoughtsHow to Break the cycle of negative Thoughts
How to Break the cycle of negative Thoughts
 
Basic Civil Engineering Notes of Chapter-6, Topic- Ecosystem, Biodiversity G...
Basic Civil Engineering Notes of Chapter-6,  Topic- Ecosystem, Biodiversity G...Basic Civil Engineering Notes of Chapter-6,  Topic- Ecosystem, Biodiversity G...
Basic Civil Engineering Notes of Chapter-6, Topic- Ecosystem, Biodiversity G...
 
Salient features of Environment protection Act 1986.pptx
Salient features of Environment protection Act 1986.pptxSalient features of Environment protection Act 1986.pptx
Salient features of Environment protection Act 1986.pptx
 
Phrasal Verbs.XXXXXXXXXXXXXXXXXXXXXXXXXX
Phrasal Verbs.XXXXXXXXXXXXXXXXXXXXXXXXXXPhrasal Verbs.XXXXXXXXXXXXXXXXXXXXXXXXXX
Phrasal Verbs.XXXXXXXXXXXXXXXXXXXXXXXXXX
 
Basic_QTL_Marker-assisted_Selection_Sourabh.ppt
Basic_QTL_Marker-assisted_Selection_Sourabh.pptBasic_QTL_Marker-assisted_Selection_Sourabh.ppt
Basic_QTL_Marker-assisted_Selection_Sourabh.ppt
 
Gyanartha SciBizTech Quiz slideshare.pptx
Gyanartha SciBizTech Quiz slideshare.pptxGyanartha SciBizTech Quiz slideshare.pptx
Gyanartha SciBizTech Quiz slideshare.pptx
 
Instructions for Submissions thorugh G- Classroom.pptx
Instructions for Submissions thorugh G- Classroom.pptxInstructions for Submissions thorugh G- Classroom.pptx
Instructions for Submissions thorugh G- Classroom.pptx
 
Benefits and Challenges of Using Open Educational Resources
Benefits and Challenges of Using Open Educational ResourcesBenefits and Challenges of Using Open Educational Resources
Benefits and Challenges of Using Open Educational Resources
 
50 ĐỀ LUYỆN THI IOE LỚP 9 - NĂM HỌC 2022-2023 (CÓ LINK HÌNH, FILE AUDIO VÀ ĐÁ...
50 ĐỀ LUYỆN THI IOE LỚP 9 - NĂM HỌC 2022-2023 (CÓ LINK HÌNH, FILE AUDIO VÀ ĐÁ...50 ĐỀ LUYỆN THI IOE LỚP 9 - NĂM HỌC 2022-2023 (CÓ LINK HÌNH, FILE AUDIO VÀ ĐÁ...
50 ĐỀ LUYỆN THI IOE LỚP 9 - NĂM HỌC 2022-2023 (CÓ LINK HÌNH, FILE AUDIO VÀ ĐÁ...
 
The Benefits and Challenges of Open Educational Resources
The Benefits and Challenges of Open Educational ResourcesThe Benefits and Challenges of Open Educational Resources
The Benefits and Challenges of Open Educational Resources
 
How to Split Bills in the Odoo 17 POS Module
How to Split Bills in the Odoo 17 POS ModuleHow to Split Bills in the Odoo 17 POS Module
How to Split Bills in the Odoo 17 POS Module
 
The impact of social media on mental health and well-being has been a topic o...
The impact of social media on mental health and well-being has been a topic o...The impact of social media on mental health and well-being has been a topic o...
The impact of social media on mental health and well-being has been a topic o...
 
How to Manage Notification Preferences in the Odoo 17
How to Manage Notification Preferences in the Odoo 17How to Manage Notification Preferences in the Odoo 17
How to Manage Notification Preferences in the Odoo 17
 
NCERT Solutions Power Sharing Class 10 Notes pdf
NCERT Solutions Power Sharing Class 10 Notes pdfNCERT Solutions Power Sharing Class 10 Notes pdf
NCERT Solutions Power Sharing Class 10 Notes pdf
 
PART A. Introduction to Costumer Service
PART A. Introduction to Costumer ServicePART A. Introduction to Costumer Service
PART A. Introduction to Costumer Service
 
The Art Pastor's Guide to Sabbath | Steve Thomason
The Art Pastor's Guide to Sabbath | Steve ThomasonThe Art Pastor's Guide to Sabbath | Steve Thomason
The Art Pastor's Guide to Sabbath | Steve Thomason
 
Additional Benefits for Employee Website.pdf
Additional Benefits for Employee Website.pdfAdditional Benefits for Employee Website.pdf
Additional Benefits for Employee Website.pdf
 
size separation d pharm 1st year pharmaceutics
size separation d pharm 1st year pharmaceuticssize separation d pharm 1st year pharmaceutics
size separation d pharm 1st year pharmaceutics
 
How to the fix Attribute Error in odoo 17
How to the fix Attribute Error in odoo 17How to the fix Attribute Error in odoo 17
How to the fix Attribute Error in odoo 17
 

Amistades Walk to Stop Underage Drinking & Drugs

  • 1. Walk to Stop Underage Drinking & Drugs REGISTRATION FORM Individuals & Families Welcome! Help Save Lives! Join our Well Paved Stroller-Friendly Path! Pet’s On A Leash Welcome! prevention efforts! REGISTRATION FEES: DATE AND TIME: Ages 18 & Up $20 / Ages 6-17 $10 Saturday, October 16, 2010 Registration forms should be submitted by October Registration starts at 7:30AM 13, 2010, accompanied by a check and mailed to: 2 Mile walk begins at 8:30AM Amistades, Inc. 1 Mile walk begins at 9:00AM 680 W. Prince Road, Suite 110 Tucson, AZ 85705 LOCATION AND DIRECTIONS: Rillito River Park Please make checks payable to Amistades, Inc. Path Onsite registration will be available; pre-registration is encouraged. Cash & checks will be accepted on COURSE: site. Maps of 1 mile and 2 mile ABOUT AMISTADES, INC: walking paths on Amistades, Inc. is a non-profit 501 (c) (3) community back. development and substance abuse prevention organization. The mission of Amistades is to provide culturally competent prevention services to reduce the use of alcohol, tobacco, and other substance abuse problems affecting Latino youth and families. REGISTRATION FORM: I certify to the best of my knowledge that I am physically fit First Name: Last Name: and have no medical condition that could likely worsen by participating in this event. I am fully aware and assume all Email: risks associated with participating in this event. I under- stand that the walk is in a public area and that participation Street Address: could be hazardous. In consideration for accepting my entry, I the undersigned, intending to be legally bound City: State: Zip: hereby for myself, my heirs, my executors, and administra- Daytime Phone: Evening Phone: tors, contractually waive and release any and all rights and claims for the damages I may suffer or which may arise Age as of 10/16/10: Total Registration $: against Amistades, Inc. and any sponsor of this event for any and all injuries occurring by reason of the negligent I plan to participate in: acts or omissions of Amistades, Inc., sponsors or otherwise from claims and damages suffered by me or to by property 1 Mile Walk arising out of connection with this event. I also grant full permission to Amistades, Inc. and sponsors to use photo- 2 Mile Walk graphs, motion pictures, videotapes, recordings, or any Signature: Date: other record of this event for any legitimate purpose. My signature verifies that I have read and agree to the terms Co-Signature: Date: stated above. I understand that unsigned entries will not (if under 18 years of age, a parent or guardian must sign) be accepted. “The Flowing Wells School District neither endorses nor sponsors the organization or activity represented in this document. The distribution of this material is provided as a community service.”
  • 2. QUESTIONS: Please send email inquiries to claudiajassostevens@amistadesinc.org or call Joe at 520-955-3907.