Kickball 4 the Kids Registration and Waiver

WAVIER OF LIABILITY

I hereby waive all claims against PepsiCo, the City of Bentonville and the Northwest Arkansas Children’s Shelter and all officers, directors and employees affiliated with PepsiCo, the City of Bentonville and the Northwest Arkansas Children’s Shelter for any injury that I may suffer from my participation in this event. I grant full permission for organizers to use photographs, videos or any other record of this event for publicity purposes. I, the undersigned, understand and agree to the above waiver.

Waiver of Liability*
- By checking this box, you agree that you have confirmed the above information from the participants you are registering and they fully agree to the above terms.
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Name of Business/Corporation*
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Player 1 Name*
Player 1 Email
Player 2 Name*
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Player 3 Email
Player 4 Name
Player 4 Email
Player 5 Name
Player 5 Email
Player 6 Name
Player 6 Email
Player 7 Name
Player 7 Email
Player 8 Name
Player 8 Email
Player 9 Name
Player 9 Email
Player 10 Name
Player 10 Email
Player 11 Name
Player 11 Email
Player 12 Name
Player 12 Email
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Phone
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Meet Lola

This young lady has been with us for more than two months. When she first arrived, she could only count to 8 and didn’t recognize numbers above 5 by sight. She also only knew about 6 letters and no sounds. She attends school on-site here at the Shelter and is in Ms. Anaiya’s elementary class. By the end of the first quarter of the school year, she can now count to 30 and identifies numbers up to 20 when shown out of sequence. She also knows 24 letters and matching sounds! This sweet girl is overcoming memory issues and a language delay. Her hard work, along with the patience and caring of Ms. Anaiya, have allowed her to make huge progress. We are so proud of her!

*name changed to protect privacy

Lola

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Lola

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