UCC 5th Annual Shop With a Hero (Hero Registration Form)
Heroes are asked to please arrive at the Newark Symphony Hall (1020 Broad Street, Newark) at 9 a.m. on Saturday, December 6, 2025.
Name
*
First Name
Last Name
Name of Agency/Department/Organization
*
Role or Title at Agency/Department/Organization
*
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Waiver & Agreement:
*
I understand that participation in this event is voluntary.
I agree to allow UCC to use event photos/videos for promotional purposes.
I release UCC from any liability related to participation in this event.
Signature
*
Submit
Should be Empty: