Strides for Seizures 5K Run/Walk

Strides for Seizures

5K Run/Walk

1 Mile Fun Run

Epilepsy Foundation of Mississippi

November 23, 2013

 

WHAT:                      Strides for Seizures 5K Run/Walk, 1 Mile Fun Run

WHEN:                      Saturday, November 23, 2013

WHERE:                    Liberty Park, 694 Liberty Park Rd., Flowood, MS 39232

TIME:                         8:00am

 

Register Below:

  • (###)###-####
  • Assumption of Risk & Release

  • Anyone who participates in Epilepsy Foundation of Mississippi’s Strides for Seizures 5k-1mile Fun/Run Walk will be doing so at his or her own risk. By my signature below, I am acknowledging that I have read this waiver/release form and I am relinquishing Epilepsy Foundation of Mississippi, its members, volunteers, and other sponsors from any liability thereof. I fully understand that my participation in this event is completely a voluntary undertaking and that I assume all risks associated with my participation including, but not limited to, heat exhaustion, falls, contact with other participants, effects of weather, dangerous traffic and the conditions of the course. I hereby waive any and all rights and claims which I, for myself and my heirs, executors, administrators and personal representatives may now or hereinafter have against and do hereby release Epilepsy Foundation of Mississippi, its members, volunteers, and other sponsors for any and all injuries, illnesses, losses or death suffered by me resulting either directly or indirectly from my participation in this race. I hereby certify that I am adequately fit and in the proper physical condition to participate in this event and that I am not participating in this event against the advice of a physician nor am I taking medications which would impair my health or ability to participate in this event. I hereby authorize the use of my name and any photographs, videotapes and other record of my participation in this event for any legitimate purpose by Epilepsy Foundation of Mississippi.
  • If under 18:

  • Raffle Tickets - *Optional

    We will be raffling off one trip (Winners Choice) for two to Maui or Kauai, Hawaii, airfare for two and a four night stay or a family trip for four to Orlando, Florida. (Includes one day passes to Sea World and one day passes to Universal Resort for a 4 night stay including airfare. Purchase your raffle tickets below ($25/each).

 

 

 

 

**** Any questions, please call EFM at 601-936-5222


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