2020 Push Your Tush Registration

 

The Medford United Methodist Women's Push Your Tush Move-a-thon is a month-long event supporting the Pastor's Discretionary Fund. To participate, complete the online form fields below to register. Upon clicking CONTINUE, you will be taken to a PayPal extension of our site for payment processing. The registration cost is $10 for children 12 and under, $15 for all others. No worries if you don't have a PayPal account, look for the credit card option.

 

First Name
Last Name
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Age
Email
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Address 1
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City
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Participant Waiver of Liability

I know that physical activities are potentially hazardous activities. I should not participate in this event unless I am medically able and properly trained for the activity that I plan to undertake. I also assume any or all other risks associated with the physical activity including but not limited to falls, the effects of weather and the condition of area where I am performing my activities, all such risks being known and appreciated by me. Knowing these facts, and in consideration of your accepting my entry fee, I hereby for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge Medford UMC, any subsidiary & facilities it utilizes, all municipalities in which I participate, the event committee, volunteers, any and all sponsors, including their agents, employees, assigns or anyone acting for or on their behalf or anyone else associated in any way with the event, from any or all claims or liability for death, personal injury or property damage of any kind of nature what so ever arising out of, or in the course of, my participation in this event(s). This waiver extends to all claims of every kind or nature what so ever, foreseen and unforeseen, known or unknown. By entering this event, I am granting permission to Medford UMC to use any pictures or likenesses of me secured at the event in any way they see fit without review, restriction, or compensation.

 

I have read, understand, and agree to this waiver for myself or for this participant for which I am the legal guardian.

 

In addition to my event fee, I would like to make a donation to benefit the Pastor's Discretionary Fund. (Donations are tax deductible. Contact office@medfordumc.org for a receipt or pick it from the church office.)

My Donation:
No Donation
$10.00
$20.00
Other Amount ($)

 

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