Breaking the Silence Suicide Awareness Walk

Sunday, September 21, 2025 at Imperial Lanes in Camanche, IA

What category would you like to sign up for? You can sign up for any of the following categories.




Waiver and Release

I Acknowledge that walking is Potentially Hazardous and that by signing, I am physically capable. I Waive/Release any and all rights and claim for damages I may have or that may have hereafter accrue to me against Speak Out Against Suicide, City of Camanche Officials and/or employees and promoters, sponsors, managers and operators associated with this event that I am entering, for any injuries incurred by me during, because of, or in travel to and from event entered.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

  • I have read, have understood, and do accept the agreement above.
  • I understand that this is a legal document with effects that I approve and authorize.
  • The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
  • I am authorized to agree to the terms of this document on behalf of the registrant.
  • If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

Electronic Signature

You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete this form.
If the person you are registering (registrant) is under 18, do not enter his/her age. You will do that on the next step. Enter your age here as the person completing the form.




Multiple signers should separate their signatures with commas.


This agreement was generated at 5:20:45 PM EDT on 05/28/2025.