Date of the Event: May 6, 2017 at 9AM.
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Child (12 and Under) ($10.00)
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Female
Age/Division
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(Choose One)
18 and Under
19 to 25
26 to 30
31 to 35
36 to 40
41 to 45
46 to 50
51 to 55
56 to 60
61 to 65
66 to 70
71 and Over
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Finish Time
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Donation
$
Event Merchandise
Convenience Fee
$0.00
Running Total
$0.00
Coupon Code
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Total
$0.00
Terms & Agreements
Terms & Agreements
*
1.) Running and walking are physical activities that involves the risk of injury. Participant assumes all risks and hazards associated with his/her participation in the event. Participant further acknowledges that this risk may involve loss or damage to him/her or his/her property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. Participant is responsible for any and all medical expenses arising from participation. Participation assumes consent. Participant hereby releases, waives liability, discharges, hold harmless, indemnifies, and covenants not to sue Southwest Counseling Associates and its associated directors, administrators, officers, managers, employees, volunteers, sponsors, advertisers, and other agents, estates or executors, from any and all liability incurred in the conduct of, and participation in, the event.
2.) This fundraising event is open to the public, and thus anyone is welcome to participate. If you are a past or present client of Southwest Counseling Associates, you are under no obligation or expectation to participate in this event. Confidentiality will be maintained by the staff of Southwest Counseling Associates.
I have read and agree to the terms above.
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