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	DISCLAIMER: By participating in the 5th Annual Walk hosted by Keep Your Hands Off Me, Inc., I accept all risks involved, including injury or accident, and release the organizers, sponsors, and affiliates from any liability. I confirm I am medically fit to join and grant permission for my image to be used in event media. *

KEEP YOUR HANDS OFF ME, Inc.

Physical Address:
1506 Market Street, Suite A/B
Wilmington, NC 28401

Mailing Address:
PO BOX 3024
Wilmington, NC 28406

Main: 910-833-5119

910-233-6926