Breast Exam

 

 

15211 Vanowen Street,
Suite 202

Van Nuys, CA  91405

 

818.782.4232 - Bus

818.782.4802 - Fax

 

Contact Us  

 

                                                                                                                            

ONLINE REGISTRATION CLOSES AT MIDNIGHT MAY 3RD, 2013

AFTER THAT YOU MUST REGISTER IN THE MORNING AT THE EVENT

T-SHIRTS WILL BE AVAILABLE ONLY AT THE EVENT

If you would like to be an exhibitor, please fill out this form.

Male Female
5K 10K

How far will you run?

Yes No
Small Medium
Large X-Large
This event is not affliliated with or sponsored by CDPH.
Waiver & Release: Must be read and acknowledged by all entrants. I know that running a road race is a potentially hazardous activity. I am medically able and properly trained for the race. I assume all risks associated with running in the event including but not limited to, falls, contact with other participants, effects of weather including heat and humidity, traffic and the condition of the roads, all such risks or racing being known and appreciated by me.  Having read this waiver and knowing these facts and in consideration of acceptance of my entry, I, for myself, and heirs, executor, or anyone entitled to act on my behalf, waive and release W2 Promotions and employees, US Army Corps of Engineers,Valley Breast Care & Women’s Health Center, all race sponsors, officials, volunteers, employees,The City of Los Angeles,The County of Los Angeles, and all governmental entities, and any of their representatives and succession from all claims of every kind or nature whatever, foreseen or unforeseen, known or unknown. I grant my permission to all of the foregoing to use any photograph, motion pictures, video, or sound recordings, or any other record of this event for any legitimate purpose.
Yes

Paying By Check

Register by April 27th for only $35
Register after April 27th for $40
The Kid's run is always $15

Your registration is not complete until you pay for your entry by pressing the yellow "Add to cart" button on the next page after you press the submit button.

If you would like to download and submit the form by post, please see the link below:
Download Mail-In Form

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