5th Annual Julyamsh
Fun Run/Walk
Saturday, July 27, 2013
(New location)

Sponsored by Benewah Medical Center – Native Lifestyle Balance – Diabetes Prevention and Diabetes Treatment Programs. This is a free event. New location for this years’ fun run/walk will be at the Coeur d’alene Casino just south of the Circling Raven Golf Course. This year we are planning a one mile and a 5k run/walk. Shirts can be guaranteed to those who register early (by July 19), however after that date we cannot guarantee that a shirt will be available. So please be sure to register early.

* Last Name:

* First Name:

* Mailing Address:

* City:

* State:

* Zip:

* Phone:

* Email Address:

* Age:

* Gender:

Male

Female

* Choose T- shirt size:

* Choose Race:

5k run/walk (8:30 am)

1 mile run/walk (8:45 am)

Terms and Conditions: In consideration of your acceptance of this race entry, I, for myself, my heirs, executors, administrators and assigns, forever release and discharge any/all rights, demands, claims for damages and causes of suit or action known or unknown, that I may have against all participating race sponsors of the Julyamsh Fun Run/Walk and Benewah Medical Centers’ Native Lifestyle Balance – Diabetes Prevention and Diabetes Treatment Programs employees and agents of such parties, for any and all injuries in any manner arising or resulting from my participation in said walk/run. I attest and verify that I have full knowledge of the risks involved in the race, that I assume those risks, that I will assume and pay my own medical and emergency expenses in the event of an accident, illness or other incapacity, regardless of whether I have authorized such expenses, and that I am physically fit and sufficiently trained to participate in this event. Youth under 10 years old participating in any event must be accompanied by an adult.

* I agree to the Terms and Conditions:

Yes.

No.

* Indicates Response Required


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