Hike for Hope 2019 Registration

To register please fill out the below form

Name*
Cellphone Number*
Email*
Address*
Emergency Contact*
Emergency Phone Number*
Shirt Size*
Number of days of participation in the march*
Vegetarian*
- Yes
- No
Would like to upgrade to a Zimmer for an additional payment*
- Yes
- No
Do you want us to open a JGive campaign for you?*
- Yes, please
- No. I will fundraise in other way
My personal fundrising goal is:
I am aware that there is a registration fee*
- Confirm
Health Declaration: I hereby declare that I have undergone a medical examination and that all the details I have provided are true and that I am fit for the hike and my physical condition was examined by a certified doctor. I am aware that Tsad Kadima or their sponsors will not be responsible for any damage which might occur to me, including physical harm before, during or after the hike nor will they be responsible for any loss of equipment. I therefore relinquish any right to damage suits against the above. I am aware that my participation is dependent on this declaration.*
- Confirm
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