#WOW Registration

Register below to ensure your spot in #WOW!

Question Title

Question Title

* 1. Please provide us with the following information:

Name *

Department *

Division *

Work Address

Alias (have fun with this!)

Email Address *

Question Title

* 2. The undersigned declares that he or she is a voluntary participant in the employer-sponsored recreational activities or fitness programs listed above. He or she hereby waives and relinquishes all rights to workers' compensation benefits under Chapter 4213 of the ORC for any injury or disability incurred while participating in the above activities or programs. The waiver is valid for two calendar years. The waiver may not bar any worker's compensation claim filed for death benefits by the employee's dependents.

Please provide your initials below: