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2. Name/family name*
3. Number of people in your group*
   -- Select One --1234567+
5. City/residence*
   -- Select One --Apple ValleyBurnsville EaganFarmingtonLakevillePrior LakeRosemountSavageOTHER

   Select the city in which you live. If your city location is not listed, select OTHER.

6. Email address

   Submit email address if you would like to be reminded of the hike yearly. This email will not be used for purposes other than this annual event.

8. Waiver and release statement*
   -- Select One --I agree

   I herby release, absolve and hold harmless the City of Lakeville and all S.O.R.R cities, its officers, employees and agents from damage resulting from any injury incurred by me or my child participating in the above-mentioned program. I/we understand that the City of Lakeville assumes no responsibility for injury before, during or after programs. The waiver of liability does not waive liability for any injuries that I obtain as the result of willful, wonton or intentional misconduct by the City or any person acting on behalf of the City.
   
   

10. Signature:*

    Checking the box below will serve as your electronic signature.

    1. I agree
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12. 1. Receive an email copy of this form.
13. Email address

    This field is not part of the form submission.

14. Submit

* indicates a required field