Walk to End Epilepsy Event Registration


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Use the form below to register for the Walk to End Epilepsy!

Based on new guidelines from the National Walk to End Epilepsy, there is NO FEE to register for any of our walk locations in Connecticut. However, every person regardless of age that is planning to walk with us must register!

Please note: Each participant must register themselves individually! Those under 18 that are walking must be accompanied by an adult and have an adult agree to the liability waiver during the registration process.

We want all members of the community to walk with us, but we cannot host these events and provide the resources for the epilepsy community without your help. We encourage every walker to make a personal donation and commit to raising funds to help us support the epilepsy community.

Registered walkers who make a $50 donation will receive an official Walk to End Epilepsy t-shirt! Your shirt will be mailed to you directly prior to the walk. Please select your correct t-shirt size when prompted.

If you have problems registering please e-mail info@epilepsyct.com or call 860-346-1924 and we'll be happy to process your registration over the phone.

UPDATE as of 5/18: Online registration will close for the Farmington walk on Friday 5/21 at 3pm.

Registration Information

Payment Information

Please review your information carefully. Once you submit your registration your information you will no be able to make any changes.


Total: $

Waiver and release of liability and assumption of risk and indemnity agreement

In consideration of being permitted to participate in the Walk to End Epilepsy in Connecticut (the "Event") as a walker, runner, cyclist or volunteer, or in any other capacity, I, for myself, my heirs, next of kin, assigns and personal representatives: Represent that I am qualified, in good health and in proper physical condition to participate in the Event and that I will stop my participation if I believe this Event becomes unsafe. Acknowledge and understand fully that there are risks and dangers of serious bodily injury and death that could result from my participation in the Event from any cause. Being aware of these risks and dangers, I have voluntarily elected to participate in the Event and I FULLY ACCEPT AND ASSUME ALL RISKS AND ALL RESPONSIBILITY FOR ANY INJURY, LOSSES AND DAMAGES TO PERSON OR PROPERTY THAT I INCUR AS A RESULT OF MY PARTICIPATION IN THE EVENT. I HERBY AGREE NOT TO SUE AND TO RELEASE, DISCHARGE, WAIVE, HOLD HARMLESS AND TO INDEMNIFY THE EPILEPSY FOUNDATION OF CONNECTICUT and their respective officers, directors, employees, volunteers, sponsors, advertisers, participants, agents and representatives FROM AND AGAINST ANY AND ALL LIABILITIES, CLAIMS, DEMANDS, LOSSES, DAMAGES, SUITS AND PROCEEDINGS, REGARDLESS OF THE CAUSE. I agree to permit the use of my name and/or likeness in any record or communication relating to the Event for any legitimate purpose, without compensation or remuneration.Helmets are required for cyclists.


By checking below, I confirm that I have read this agreement and understand that I have given up substantial rights by agreeing to it.




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THANK YOU TO OUR SPONSORS!

Nationwide Sponsors

Greenwich Biosciences
SK Life Science

Signature Sponsors

EISAI
Liva Nova
UCB

Sunovion

Success Sponsors

HHC Ayer Neuroscience Institute

Neurelis

Uconn Health

Medtronic

The Thirsty Gull


Hope Sponsors

AJP Electric
Amity Lacross Association

Friend Sponsors

The Blaine Family

Tolland Lion's Club

People's Bank

Housatonic Valley Well Pump Services

Special Thanks To

Cahill Septic Service

Greenwich Magazine Moffly Media