FirstLast

Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code

• Yes
• No

• Yes – $25.00
• No – $0.00

• Yes
• No

• Yes
• No

• Yes
• No

e.g., mobility assistance, interpreter

• I Agree

By registering for and participating in this event, I acknowledge and agree to the following:
I understand that participation in this event involves certain inherent risks, including but not limited to injury, illness, property damage, or other losses. I voluntarily assume all risks associated with my participation in this event.
I, on behalf of myself, my heirs, executors, and assigns, hereby release and hold harmless Glen Neighborhood Improvement Association (GNIA), its officers, employees, volunteers, sponsors, and affiliates from any liability, claims, or demands for injuries, losses, or damages arising from or related to my participation in the event, whether caused by negligence or otherwise.
I certify that I am physically fit and capable of participating in the event, and I agree to comply with all event rules and instructions.
By submitting this registration, I acknowledge that I have read, understood, and agree to this release of liability.

• I Agree

I agree that any image of me at the event can be used for media or marketing purposes.

• Women’s CERT Training
• Men’s CERT Training
• Active Shooter Training

Which trainings will you be joining us for?

• Yes
• No
• Maybe

A GNIA member will be in touch with you regarding partnering with us.

• Member registration – $0.00
• Register as a member of GNIA – $25.00
• Non-member CERT training – $5.00
• Non-Member Active Shooter Training – $5.00
• Member donation – $5.00
• Community Support Sponsorship – $250.00
• Community Pillar Sponsorship – $500.00
• Community Builder Sponsorship – $1,000.00