First Name *

Last Name *

Email *

Phone

Name of Event *

Date of event *

The above participant is under 18 years of age * Yes No

Parent/Legal Guardian First Name *

Parent/Legal Guardian Last Name *

I am Halliburton employee * Yes No

I have read and agree to the above outlined terms * Yes

I have read and agree to uphold Business Practice Policy 4-11254 – Approved Volunteer Activities and Time – U.S. and Canada * Yes

I understand that the Company will be tracking volunteer time * yes

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