Junior Service League of Grand Junction, Colorado

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Saturday October 3, 2009

What is Walk 4 Life?

Both a fun and fund-raising event, Walk 4 Life brings people together to promote breast cancer awareness,

education, detection, and support.

Proceeds from Walk for Life will fund mammograms and cancer screenings for low income, uninsured individuals

in Mesa County. One hundred percent of the proceeds stay in Mesa County for mammogram services.

Thank you to all of our Walk 4 Life sponsors!

Corporate Sponsorship
We also welcome and encourage the participation of local businesses through corporate sponsorship. Direct event

sponsors will have their business acknowledged in the Daily Sentinel and on this website.

Donations
Are you unable to join us for Walk 4 Life? We would be honored if you would like to support Walk 4 Life with a charitable

donation, even if you are unable to join us personally on October 4th. Select a donation amount (adjust cart quantity for larger donations):

Schedule of Events
Saturday, October 3, 2009

8:30 - 9:00am

Check-in and parking at Western Colorado Botanical Gardens,

655 Struthers Ave. (click here for a map)

9:00am

Opening ceremony and 5K (3 mile) walk to Eagle Rim Park begins at the Elizabeth B. Harris Amphitheater.

Walk 4 Life Registration Pre-registration ends September 25th
Individual	$25 (Save $5 when you pre-register - $30 registration at the event)
Teams of 5-10 walkers	$20 each
Teams of 11+ walkers	$15 each

Individual Registration

Name*

Phone*

Address

City

State

Zip Code

T-shirt Size

I am a breast cancer survivor

Waiver
In consideration of my signature on this entry form, I hereby for myself, my heirs, executors and administrators, waive any and all claims I may have for damages against the Junior Service League of Grand Junction, the event sponsors and all individuals associated with the event, their representatives and successors, and assigns for any and all injuries suffered in connection with this event, including pre and post walk activities.

I have been warned that I must be in good health to participate in this event, and attest and verify that I am physically able to participate in this event. I hereby grant permission to the Junior Service League of Grand Junction and its authorized agents to use my name and photographs, videotapes, motion pictures, recordings and any other record of my participation in this event for any purpose.

*I Agree to the Waiver

Small Team Registration
(5-10 walkers)

Team/Organization Name

Team Captain's Name*

Team Captain's Phone Number*

Walkers' Information

Name

Address

City

State

Zip

T-shirt
Size

Breast Cancer Survivor

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

Waiver

In consideration of my signature on this entry form, I hereby for myself, my heirs, executors and administrators, waive any and all claims I may have for damages against the Junior Service League of Grand Junction, the event sponsors and all individuals associated with the event, their representatives and successors, and assigns for any and all injuries suffered in connection with this event, including pre and post walk activities.

I have been warned that I must be in good health to participate in this event, and attest and verify that I am physically able to participate in this event. I hereby grant permission to the Junior Service League of Grand Junction and its authorized agents to use my name and photographs, videotapes, motion pictures, recordings and any other record of my participation in this event for any purpose.

*I Agree to the Waiver

Large Team Registration (11+ walkers)
Team/Organization Name
Team Captain's Name*
Team Captain's Phone Number*


Walkers' Information
	Name	Address	City	State	Zip	T-shirt Size	Breast Cancer Survivor
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)

Waiver In consideration of my signature on this entry form, I hereby for myself, my heirs, executors and administrators, waive any and all claims I may have for damages against the Junior Service League of Grand Junction, the event sponsors and all individuals associated with the event, their representatives and successors, and assigns for any and all injuries suffered in connection with this event, including pre and post walk activities. I have been warned that I must be in good health to participate in this event, and attest and verify that I am physically able to participate in this event. I hereby grant permission to the Junior Service League of Grand Junction and its authorized agents to use my name and photographs, videotapes, motion pictures, recordings and any other record of my participation in this event for any purpose.
*I Agree to the Waiver