Brainfreeze Polar Plunge

Name on Your Web Page*

Your own web address will be
https://ssl.charityweb.net/navhope/brainfreezeplunge/ENTERED_TEXT.htm

Fund Raising Goal*

Your Name and Contact Info:

You will be able to log in to personalize your own web page and view donations.

First Name*

Last Name*

Address*

Address, line 2

City*

State/Province*

Zip/Postal Code*

Country*

Preferred Phone

E-mail Address (and username)*

Please add me to your e-mail distribution list.

Password*

Confirm Password*

T-shirt size

* Waiver*- I know that plunging into the lake could be potentially hazardous for me or for my minor child. I (he/she) will not participate in the Brainfreeze Polar Plunge on February 29, 2020 unless medically able. I assume all risks associated with participation in this event including, but not limited to, contact with other persons, effects of the weather including freezing temperatures and water, weather conditions and conditions of the roads, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, I for myself, and anyone entitled to act on my behalf, waive and release Navigate Hope Inc, Big Island LLC, Island Entertainment LLC, Margaritaville Lanier Island and all of their affiliates and subsidiaries, all Brainfreeze Polar Plunge volunteers, all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I acknowledge Navigate Hope Inc is not responsible for any valuables or personal property. Parents or guardians of participants under 18 will need to sign this waiver on the day of the event. Download Waiver

Brainfreeze polar plunge

Lake Lanier Islands - Landshark landing

February 29, 2020

Registering as an Independent (not part of a team)

Your Name and Contact Info: