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Registration
User Information
Name
(Required)
First
Last
Email
(Required)
If you have a @wfu.edu email, please use that email address.
General Information
Gender
(Required)
Female
Non-Binary
Male
Prefer not to answer
Other
Other Gender Specification
(Required)
Bio
(Required)
Image
Accepted file types: jpg, gif, png, Max. file size: 23 MB.
Recommended photo size: 250 x 250.
Classification
(Required)
First Year
Sophomore
Junior
Senior
Alumni
Graduate Student
Faculty / Staff
Event Information
What is your personal goal to raise?
(Required)
$100
$500
$1,000
$2,500
$5,000
$10,000
What size t-shirt do you want?
(Required)
Small
Medium
Large
X-Large
XX-Large
What shift will you be participant?
(Required)
All 12 Hours
First 6 Hours
Last 6 Hours
Is there anyone you are dancing for?
Team
(Required)
Create my own team
AED (AED Pre-Health Honor Society)
Alpha Delta Pi
Alpha Epsilon Pi
Alpha Kappa Alpha
Alpha Kappa Psi
Alpha Phi Omega
Alpha Sigma Phi
Angelou Hall
AAP (Anthony Aston Players)
Babcock (Babcock Hall)
Bayer-Nops
Best Buddies
Black Student Alliance
Board Game Club
Bostwick (Bostwick Hall)
Campus Kitchen
WFCC (Catholic Community)
CHAARG
Chi Omega
Chi Psi
Chi Rho
Club Rowing
Club Swim
Collins (Collins Hall)
Davis Hall
Delta Sigma Theta
Delta Xi Phi
Delta Zeta
Dogwood (Dogwood Hall)
Efird Hall
GSAS (Graduate School of Arts & Sciences)
Hindu Student Alliance
Huffman Hall
Individual Dancer
Innuendo
Inter-faith!
Johnson Hall
KA (Kappa Alpha)
Kappa Alpha Psi
KAO (Kappa Alpha Theta)
Kappa Beta Gamma
Kappa Delta
Kappa Kappa Gamma
Kappa Kappa Psi
Kappa Sigma
Kitchin (Kitchin Hall)
Kappa Kappa Psi (KKΨ)
Lambda Chi Alpha
Luter Hall
Magnolia Hall
Martin Hall
Minor Variation
Momentum (Momentum Dance Crew)
Muslim Student Association
NCA (North Campus Apartments)
Omega Psi Phi
OLAS (Organization of Latin American Students)
Pi Kappa Alpha
Pi Kappa Phi (Pi Kappa Phi)
Polo Hall
Poteat (Poteat Hall)
Reformed University Fellowship
Rugby Team
Running Club
Sigma Alpha Epsilon
Sigma Chi
Sigma Pi
South (South Hall)
Student Government
Taylor (Taylor Hall)
Team Whales
The Globe
Theta Chi
Theta Tau
Theta Tau
Tri Delta
WNS Alumni (Wake 'N Shake Alumni)
Wake 'N Shake Committee Members
Wake 'N Shake Exec
Wake Forest Cheer Team
WFU Alumni
WFU Athletics
WFU Band
WFU Dance Team
Grads in Motion (WFU Graduate Students)
Young Life (Young Life College)
Enter your new team's name
(Required)
Enter your team's nickname if applicable
What is your team's goal to raise?
(Required)
$500
$1,000
$5,000
$10,000
$15,000
$25,000
$50,000
Safety & Medical Information
Emergency Contact Name
(Required)
First
Last
Emergency Contact Phone
(Required)
Dietary Restrictions
Vegan
Vegetarian
Gluten-Free
Dairy-Free
Nut-Free
Other
Other Dietary Restrictions
(Required)
Agreement Information
Please read the following agreement:
(Required)
Release and Assumption of Risk Agreement (scroll to view full message)
This Release and Assumption of Risk Agreement (this “Agreement”) pertains to Activity described below.
Activity: Wake 'N Shake
Sponsor: Wake Forest University (“Wake Forest”), acting through the Office of Civic and Community Engagement
Activity Description: Wake 'N Shake is a 12-hour dance marathon in the Reynolds Gym. Participants will dance, sing, run, walk and otherwise engage in high energy activity throughout the day. Participants will be asked to stay on their feet for the entire event. Participants will be joined by hundreds of other individuals and have the opportunity to engage in special games, challenges and activities throughout the day. The event concludes with a final hour of remembrance where participants will gather together to honor all those who have lost their lives to or are fighting against cancer. Participants are raising awareness and funds to find a cure for cancer. All proceeds benefit the Brian Piccolo Cancer Research Fund at Atrium Health Wake Forest Baptist. ____________(Scroll for rest of agreement)__________________
In consideration of the opportunity to participate in the above-identified activity, the undersigned agrees to the following:
1. Voluntary Participation. I understand that Wake Forest does not require me to participate in the Activity. I voluntarily choose to participate and I voluntarily assume all risks associated with taking part in this Activity.
2. Risks. During the Activity I will have the opportunity to participate in certain activities which may expose me to potential risks and dangers. Some of the risks associated with the Activity include, but are not limited to, illness, physical injuries such as sprains, muscle strains, and abrasions, and/or aggravation of existing health problems. These examples are not intended to be all-inclusive, but merely to exhibit my awareness of the risks inherent in this Activity and I understand and assume these risks.
3. Release of Claims. Knowing the risks described above, and in consideration of being allowed to participate in the Activity, I hereby assume all risks and responsibilities surrounding my participation and I release Wake Forest, its officers, trustees, agents and employees from any and all liabilities, claims, or demands for damages for personal injury, disability, property damage or other loss, damage, or injury of any kind that I may suffer or sustain as a result of my participation in the Activity, unless such injury or damage is caused by the gross negligence of Wake Forest or its employees. To the extent permitted by law, I further agree to indemnify and hold harmless Wake Forest, its officers, trustees, agents and employees, from any and all loss, liability, damage or costs that it or they may incur as a result of my participation in the Activity or arising from or out of any of my acts or omissions related to the Activity.
4. Medical Treatment Authorization. Volunteers and Wake Forest representatives assisting in the Activity are authorized (but are not obligated) to take any actions they consider to be warranted under the circumstances regarding my health and safety while participating in the Activity. I agree to pay all expenses related thereto and hereby release Wake Forest and its officers, trustees, employees and agents from any liability for such actions taken for my health and safety and for payment for any such treatment.
5. Binding Effect; Construction; Forum. I acknowledge that this Agreement will be binding on me, as well as members of my family, my spouse, heirs, assigns and personal representative. This Agreement will be construed under the laws of the State of North Carolina, which will be the forum for any lawsuits filed under or incident to this Agreement or to Activity. If any portion of this Agreement is held to be invalid, the balance, notwithstanding, shall remain in full force and effect.
In consideration of the opportunity to participate in the above-identified activity, I knowingly and voluntarily:
1. Acknowledge that I have: (i) had a physical examination and have been given my physician’s permission to participate, or (ii) I have decided to participate in the Activity without the approval of my physician;
2. Represent that I am physically ready to participate in the Activity;
3. Acknowledge that, if I am a Wake Forest employee, the Activity is not within the course and scope of my employment with Wake Forest. I specifically acknowledge my waiver below shall include rights to workers’ compensation benefits for any injury or disability incurred while participating in the Activity;
4. Acknowledge that any Wake Forest personnel or agents attending the Activity are not necessarily medically trained to care for any physical or medical problems of individuals participating in Activity;
5. Agree to follow all the safety procedures and instructions of Activity coordinators (e.g., appropriate dress, proper use of safety equipment, etc.)
6. Acknowledge that due to the on-going COVID-19 pandemic, the Activity is subject to alteration, postponement or cancellation at the discretion of the Activity organizers. If event details change you will be notified via the email you use to register. And while participating in the Activity, I agree to abide by all University and event specific guidelines related to COVID-19.
I am eighteen years of age or older and am fully aware that my participation in the Activity is on a voluntary basis and is not mandatory, and I will receive no academic credit or employment compensation for my participation in the Activity.
_____________________
Note: As part of your registration fee, you will receive a WFU Wake 'N Shake t-shirt. Please note that exact sizing is not guaranteed and priority is given based on the time of your registration.
I agree to terms and conditions written above.
Potential Donors
Please submit the contact information of friends or family members.They will automatically be sent an email telling them about Wake 'N Shake 2025 and your participation in the event, and asking if they would be willing to support you by donating to the Brian Piccolo Cancer Research Fund on your behalf
Potential Donor Name
(Required)
First
Last
Potential Donor Email
(Required)
Add additional donor
Remove additional donor
Maximum of 15 potential donors