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2017 CROSSWINDS 5K Saturday, September 2 nd 16 th annual This is a community outreach event to benefit the Patient Special Needs Fund of the Wilmot Cancer Institute’s Sands Cancer Center at UR Thompson Health. This fund is used to help cancer patients pay for supplies and procedures that are not covered by health insurance; thus improving their quality of life. CROSSWINDS 5K This is a 3.1 mile route starting and finishing at Crosswinds Church. The Crosswinds 5K is a growing community-wide event. Runners and walkers of all ages are encouraged to participate. Proceeds benefit the Wilmot Cancer Institute’s Sands Cancer Center Patient Special Needs Fund

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Page 1: 5K S D N WI S S RO C S - d368g9lw5ileu7.cloudfront.net e t n e C r e c n a C s d n a S s ... representatives and successors from all claims and liabilities of any kind arising out

2017 CROSSWINDS 5K Saturday,September2

nd

16thannual

This is a comm

unity outreach event to benefit the Patient Special N

eeds Fund of the W

ilmot C

ancer Institute’s Sands C

ancer Center at U

R Thom

pson H

ealth. This fund is used to help cancer patients pay for

supplies and procedures that are not covered by health insurance; thus

improving their quality of life.

CROSSWINDS 5K

This is a 3.1 mile route

starting and finishing at C

rosswinds C

hurch.

The Crossw

inds 5K

is a growing com

munity-w

ide event. R

unners and walkers

of all ages are encouraged to participate.

ProceedsbenefittheWilmotCancerInstitute’sSandsCancerCenterPatientSpecialNeedsFund

Page 2: 5K S D N WI S S RO C S - d368g9lw5ileu7.cloudfront.net e t n e C r e c n a C s d n a S s ... representatives and successors from all claims and liabilities of any kind arising out

------------------------------------------------------------------------------------------------------------------------------

Name _________________________________________________ Age on Race Day _______ Address ______________________________________________ E-mail ________________________________________ City _______________________________ State ________ Zip ______________ Phone _(_____)_______________________ Male Female Date of Birth ______/______/_______ Check here if you wish to include an additional donation Shirt Size - (circle one) S M L XL XXL to the SANDS Cancer Center-- add’l amount: ___________ Waiver and Release: I understand that running a road race is a potentially dangerous activity. I should not enter and run unless I am medically able and properly trained. I assume all risks associated with this, including, but not limited to : fall, contact with other runners, humidity, temperature, foul weather, traffic and road conditions; all risks being accepted by me. Having read this waiver and knowing these facts, I for myself and any entitled to act on my behalf, waive and release Crosswinds Wesleyan Church, City of Canandaigua, Town of Canandaigua, County of Ontario, State of New York, Ferris Hills at West Lake, the race directors, sponsors, and volunteers and their representatives and successors from all claims and liabilities of any kind arising out of my participation in this event. I further grant permission to all foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any purpose whatsoever. I understand that all entry fees are non-refundable.

Signature: __________________________________________________ Date: ____________________ (Parent or guardian must sign if under 18 yrs. of age)

OFFICIAL USE ONLY

CROSSWINDS 5K W

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TC m

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Please make checks payable to: Crosswinds 5K detach bottom portion and mail to: Crosswinds 5K (Please PRINT) 3360 Middle Cheshire Road

Canandaigua, N.Y. 14424

Our

cou

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is c

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to b

e ac

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ONLINE Registration available – www.crosswindsonline.org/5k