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Edward I. & Freda Fleischman Residence
Louis C. & Edith B. Blumberg Plaza
6710 West Maple Road
West Bloomfield, Michigan 48322
(248) 661-2969
Fax (248) 661-1628

 

 

Walk of Ages

Step 1
Please read and accept the Terms & Conditions and select from one of the registration packages below. You will then be taken to a secure PayPal payment page for Step 2. If you prefer you can fax or mail a printable version of this form instead.

 Terms & Conditions

We recognize and hereby expressly assume the risks of illness and injury inherent in any exercise program, and I am participating in this event upon the express agreement and understanding that I am hereby waiving and releasing Walk of Ages and any and all of their affiliated corporations and/or associations.

I hereby give the right and permission to Walk of Ages to use my recorded voice and photographic images through any medium.  I waive any right to inspect or approve the printed matter that may be created in conjunction with the eventual use for any Walk of Ages program.

By completing this form I confirm that I have read the risk and permission statement and agree to the terms and conditions set forth by Walk of Ages Program.

 Registration Entry Fee
Individual Fee
early registration
$18.00
includes 1 T-shirt 
day of event
$20.00
Family Fee
early registration
$36.00
up to 2 adults, 4 children &  2 T-shirts
day of event
$40.00
Team Fee
early registration
$125.00
up to 5 members &  5 T-shirts
day of event
$130.00
Copyright 2007 - Auxiliary for Jewish Home & Aging Services