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Adams County Suicide Prevention Walk Registration-2026
This event will be held on Saturday, September 19th, 2026 starting at 9AM at Adams-Friendship Middle School. NO entry fee. For more information, call 608-339-4559.
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1.
Participant's contact information:
(Required.)
Name
Email Address
Phone Number
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2.
I am 18 years or older
(Required.)
Yes
3.
Please enter the first and last name(s) of others that you are also registering for (*Please note, only parents/guardians can register those under age 18*):
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4.
How did you hear about this event?
(Required.)
Facebook
Radio
Newspaper
Word of Mouth
Other (please specify)
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5.
I grant permission to Adams County and their agents or employees, to use my name and photographs taken of me (and participants under the age of 18 of which I am their parent/guardian) in conjunction with its Suicide Prevention Walk on September 19th, 2026, for publication on the Adams County Health & Human Services- Division of Public Health Facebook page and in publications such as brochures and newsletters. I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive the right to royalties or other compensation arising from or related to the use of the photograph. I am 18 years of age or older, or have had my parent or guardian electronically sign, and I am competent to contract in my own name. I have read this release and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to electronically signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
(Required.)
I agree
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6.
I understand that participation in the 2026 Adams County Suicide Prevention Walk involves activities that may be hazardous. Participants therefore agree to expressly assume any inherent risk or injury or harm and hereby release Adams County from any/all liability for injury, illness, death and/or property damage that may result due to participant(s)' involvement in this event. I acknowledge that I have read, understand and agree to this Release of Liability and Assumption of Risk for myself and all participants I am registering that are under the age of 18 and of which I am their parent/guardian.
(Required.)
I agree