JOIN YOUR HEALTH AMERICA, INC, A COMMUNITY NON-PROFIT ORGANIZATION, SINCE 1990, TAKING THE LEAD ROLE AND OTHER CONCERNED VOLUNTEERS AND ORGANIZATIONS IN OUR EFFORT TO REDUCE AND/OR ELIMINATE THIS PAINFUL AND DEADLY DISEASE, OBESITY & DIABETES.
IT STARTS WITH US – HELPING OUR CHILDREN AND EACH OTHER
WHERE: WELCOME ALL PARK
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4225 Will Lee Road
College Park, GA 30349
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WHEN: September 15, 2012 – Saturday
TIME: 8AM
DISTANCE: 7K= 4.3 miles Run and/or Walk
AWARDS: 1st and 2nd Finishers-Trophies(Male and Female) All Finishers – Certificates & Refreshments
REGISTRATION FEES:
Until August 1 August 2 Race Day
$25 $25 $30
REGISTER: www.Active.com , or copy &complete form below.
RACE REGISTRATION
Please print clearly in ink. One entry form per person
Last Name
First
M.I.
Date
Street Address
Apartment/Unit #
City
State
ZIP
Phone
E-mail Address
Company/
Team Name
Hat Size (Adjustable)
M _ L _ EVENT: 7K Walk _ 7K Run _
Fees $____________
Donation $____________
Total $____________
Make Checks/Money Orders payable to Your Health America, Inc.
Entry Fees and/or Contributions are non-refundable or transferrable.
Mail To: Your Health America, PO Box 312419, Atlanta, GA 31331.
RELEASE and WAIVER
In consideration of this entry, in the Get Slim Road Run and Walk (7K Run & 7K Walk), I waive any and all claims for myself and my heirs against Your Health America, Inc officials, sponsors, and volunteers of this event for injury or stress which may result directly or indirectly from any participation. I further stress that I am in proper condition to participate in this event. I give permission to authorize emergency treatment if necessary. I permit the use of my name and/or picture for any broadcast or telecast or other account of the event. However, YHA reserves the right in case of emergency due to weather or any unforeseeable circumstances to reschedule or cancel this event. If this event is cancelled you may request a refund or tax deductible contribution letter.
__________________________________________________
Applicant Signature