Healing Walk

Join us every other Friday at 11am for a relaxing walk as we discuss grief and loss in a supportive social atmosphere.

Please fill in the registration form below, and we'll contact you with more information.

Healing Walk Registration Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Date of birth

Emergency Contact Name(Required)

Emergency Contact Phone(Required)

Can you please share your relationship to the person who has died? (e.g., spouse, sibling, etc.)(Required)

Can you please share with us when this person died?(Required)

Answering the following question will help inform us whether trauma is involved, which will enable us to support you more effectively. Can you please share the cause of death for the person identified earlier?

Consent(Required)

I agree to the below liability waiver and release.

**KEMP CARE NETWORK – HEALING WALK LIABILITY WAIVER & RELEASE**

By registering for and participating in the **Healing Walk** organized by **Kemp Care Network**, I acknowledge and agree to the following terms:

1. **Assumption of Risk**
I understand that participation in an outdoor walking activity involves inherent risks, including but not limited to, uneven terrain, weather conditions, wildlife encounters, and potential physical exertion. I voluntarily assume all risks associated with participating in the Healing Walk.

2. **Health & Fitness**
I affirm that I am physically fit to participate in this activity. I acknowledge that it is my responsibility to consult with a healthcare professional if I have any concerns about my ability to safely engage in this walk.

3. **Release of Liability**
I hereby release, waive, and discharge **Kemp Care Network**, its organizers, staff, volunteers, affiliates, and any associated entities from any and all claims, liabilities, damages, or losses that may arise from my participation, including injury, illness, or property damage, whether caused by negligence or otherwise.

4. **Medical Treatment**
In the event of a medical emergency, I authorize Kemp Care Network to seek medical assistance on my behalf. I understand that I am responsible for any medical costs incurred as a result of my participation.

5. **Personal Responsibility**
I agree to follow all safety instructions and guidelines provided by event organizers. I understand that failure to comply with these guidelines may result in my removal from the activity.

6. **Photo & Media Release**
I grant Kemp Care Network permission to use photographs or recordings taken during the event for promotional or educational purposes, without compensation.

7. **Acknowledgment of Understanding**
I have read and fully understand this Liability Waiver & Release. By registering for the Healing Walk, I voluntarily agree to these terms and waive any claims against Kemp Care Network and its affiliates.

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