cardiovascular disease foundation 5k run/walk 4/10 in oceanside ca - registration flyler

5K Run/Walk For Life® & Free Community Health Fair 5K Run/Walk For Life® & Free Community Health Fair Sunday, April 10, 2011, 8am - 2pm Oceanside Pier, 200 N. Strand, Oceanside, CA, 92054 Adults - $20 After March 10 - $30 Kids 12 & Under are FREE! Kids 12 & Under are FREE! Military , Fire, Police & their Families are FREE! Military , Fire, Police & their Families are FREE! HOLD HARMLESS AGREEMENT (ALL PARTICIPANTS MUST SIGN): I acknowledge that this athletic event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not l imited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people including, but are not limited to, part icipants, volunteers, spectators, coaches, event official, and event monitors, and/or producers of the even t, and lack of hydration. These risks are not only inherent to athletics, but are also present for volunteers. I hereby assume all of the risks of participating and/or volunteering in this event. I realize that liability may arise for negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them or because of their po ssible liability without fault. I certify that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person. I acknowledge that the Hold Harmless Agreement form will be used by the event holders, sponsors and organizers of the event in which I may participate, and that it will govern my actions and responsibilities at said event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A)Waive, Release and Discharge from any and all liability for my dea th, disability, personal injury, property damage, property t heft or actions of any kind which may hereafter occur to me including my traveling to and from this e vent, THE FOLLOWING ENTITIES OR PERSONS: Cardiovascular Disease Foundation, City of Oceanside, their directors, officers, employees, volunteers, representatives, and agents, the event holders, event sponsors, event volunteers; ( B) Indemnify and Ho ld Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in t his event, whether caused by negligence of releases or otherwise, I hereby consent to receive medical treatment which my be deemed advisable in the event of injury, accident and/or illness during this event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video or film likeness to be used for any l egiti- mate purpose by the event holders, producers, sponsors, org anizers and assigns. The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I hereby certify that I have read this document: and, I understand its content. X___________________________________________ ______________ Signature (If under 18 years old, parent/guardian signature required) Date REGISTRATION & DONATION FORM Directions & Parking: From I-5 take Mission Ave. exit (Exit 53), go toward Downtown. T urn slight right onto Mission Ave. heading West. Turn left onto N. Pacific St. Turn right onto Seagaze Dr. Free Parking Garage at Seagaze Dr. & S. Cleveland St. Event is Held in Rain or Shine. Sorry , No Dogs Allowed. Questions? - [email protected] Make Checks Payable to: Walk For Life Send Donations & Form to: Cardiovascular Disease Foundation 3088 Pio Pico Dr. Ste. 202 Carlsbad, CA 92008 Run/Walk Entry Fee - $20.00 $______ After March 10 - $30.00 $______ Donations Enclosed $______ I won’t be able to attend. My donation is enclosed. $_____ Total Enclosed $______________ My T-Shirt size is S__ M__ L__ XL__ Register for the 5K Run/Walk or make a Donation: By Mail, By Ph one - (760) 730-1471, at Event, or Online at Funds raised benefit free services and programs that teach San Diego County residents of all ages how to prevent, treat, and diagnose heart disease, stroke, and its risk factors. CVDF’s Tax ID Number is: 05-0536041

cardiovascular disease foundation 5k run/walk 4/10 in oceanside ca - registration flyler

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