Participant's Name:
Address:
Email Address:
Telephone Number:
Affliation (school,church,organization)
Please identify if you are a minor*	YES NO
Please identify if you are a teacher	YES NO
If teacher specify # of people walking with you
Comments (optional)

Participant Waiver: By submitting the registration online the participant agrees to hold harmless the City of Chicago, the Chicago Park District, UNA USA Greater Chicagoland for any accident or injury which may occur while participating in Silence the Violence Walk on October 26, 2008.

* If you are a minor you will need to send us the waiver form signed by your parents or guardian. You may mail the signed waiver form (click here) to: Claudia Jaccarino, c/o CultureConnect, 1632 North Hudson Ave., Suite 3, Chicago, Illinois 60614 . Alternatevely you may email a scanned copy of the signed waiver form to: cjaccarino@unachicago.org

Pledges & Sponsorships: If you wish to have someone sponsor you in this event you may print the Pledge sheet and give it to your sponsor. Alternatively you may direct your sponsor to this website and request the sponsor to make the pledge directly through “PayPal” by clicking the appropriate button below. All participants making a pledge or sponsored for $20 or more will receive a “Save Darfur” T-Shirt at the event. Click here for the T-Shirt image.

Individual Pledge Pledge for a School or an Organization Pledge for a Participant Individuals wishing to make a pledge please use this button. While making the payment please include the name of the School or organization in the "Special Instructions" box. While making the payment please include the name of the Darfur Walk Participant in the "Special Instructions" box.

For additional information contact us at: info@unachicago.org / 312-933-6123