Health Equity and Energy Challenge Registration Form

Please select your year of schooling:(Required)
Will you be applying as an individual or as a group?(Required)
Challenge participants must comply with all of the rules of the Contest, including, but not limited to, any restrictions on age and/or county residency, and have not committed any fraud or deception in entering the Contest or claiming the Prize. The Challenge participant must affirm that he/she is not an employee or relative of an employee of Acenda Integrated Health or Atlantic City Electric. In consideration of the receipt of the Prize, the winner agrees to be solely responsible for any and all taxes and/or other fees, including, but not limited to, any federal state or local income taxes, that are or may become payable as a result of participating in the Challenge and/or receipt of the Prize. The winners agree to allow Acenda, Inc. and/or its designees the right to use winners’ name, likeness, portrait, and/or recorded voice for an unlimited period of time in order to advertise, promote or publicize the Challenge. The winner expressly releases Acenda, Inc., and any sponsors of the Challenge, and their respective officers, directors, agents, parent companies, subsidiaries and employees, from any and all claims, demands and/or causes of action of any nature or kind whatsoever, whether presently known or unknown, foreseen or unforeseen, that he/she may have, or may subsequently acquire, as a result of participating in the Challenge and/or receipt of the prize.