Register for 2023 5 K Race – Eastern Sierra Cancer Alliance

Eastern Sierra Cancer Alliance

Sixth Annual Colorectal Cancer Awareness Walk & Run
Saturday, March 25, 2023 @ Brown’s Town

IN-PERSON EVENT: Saturday, March 25, 2023, at Brown’s Town Campground TIME: Registration beings at 8:30 am. Walk & Run Kick‐Off at 9:00 am.
Photos: Share your photos of your walk/run after the event here.

Pre-Registration: March 22^nd at Northern Inyo Healthcare District Breezeway, 150 Pioneer Ln, Bishop CA, 11am to 1pm
or March 20^th and 21^st, 23^rd and 24^th at Shallcross & Associates, 250 Sneden St, Bishop CA, 11am to 1pm.

Blue Ribbon Walk & Run Registration Form

DOWNLOAD RACE REGISTRATION (PDF)

2023 Run/Walk Registration

Please fill out the below information. Thank you

Sixth Annual Colorectal Cancer Awareness Walk & Run
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*

(Will save paper & postage next year)
Phone*
Type of registration*
- $40 - Adult/Teen
- $20- Youth 12 and under
(Early registration prices valid until October 10)
Raffle Tickets Quantity
Price: $1.00
Raffle Winners will be announced on Facebook live on Saturday, October 15, 2022 at noon. You will be contacted via email if you win! You know the good prizes...this is the year to SPLURGE!
Age on Race Day*
T-Shirt Size*
(Adult sizing)
T-shirt Pickup/Delivery*
- Please mail my shirt and race bib
- I will pick up my shirt and race bib (place/times listed below)
First 120 registrants will receive a 2023 Event T‐Shirt (Supplies are limited so register early!) Pre‐Registration: March 22nd at Northern Inyo Healthcare District Breezeway, 150 Pioneer Ln, Bishop CA, 11am to 1pm or March 20th and 21st, 23rd and 24th at Shallcross & Associates, 250 Sneden St, Bishop CA, 11a to 1pm.
Waiver
I, the undersigned as a condition of participating in this event, do hereby for myself, my heirs, executors, and administrators, indemnify and hold harmless the Eastern Sierra Cancer Alliance, and any subsidiaries and related entities, such as its officers, directors, sponsors, employees, lessees, or any agencies or individuals associated with this event for any and all injuries sustained by me in the course of this event. I hereby waive any and all rights of claim for damages I may have against the foregoing, their officers, directors, sponsors, or any agencies or individuals associated with this event for any and all injuries sustained by me in the course of this event. I understand that children age 12 and under registered to participate must be accompanied by a parent or guardian and may not be left unattended by that parent or guardian. If I choose to bring a dog on the walk or run, I will keep the dog on leash and under control at all times and I will be responsible for all of its actions, financially and otherwise. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, verbal or written statements, or any other record of this event for any legitimate purpose without my consent. I am of legal age, have read this release, fully understand it ,and freely agree to all of its terms.
Signature*

Please type your name. EVERY participant must sign! Participants under age 18 must have a parent/guardian signature.
Date of Signature*
MM slash DD slash YYYY
Payment
You are AMAZING for adding more!
Total Registration Cost
$0.00
I wish to pay by*
- PayPal
Payment Method

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Please make your check payable to Eastern Sierra Cancer Alliance “ESCA,” include a note about which participant(s) the check covers, and mail by October 10th to:

ESCA
P.O. Box 1523
Bishop, CA 93515
Name
This field is for validation purposes and should be left unchanged.

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Eastern Sierra Cancer Alliance

Sixth Annual Colorectal Cancer Awareness Walk & Run Saturday, March 25, 2023 @ Brown’s Town

Blue Ribbon Walk & Run Registration Form

2023 Run/Walk Registration

Sixth Annual Colorectal Cancer Awareness Walk & Run

Waiver

Payment

ESCA P.O. Box 1523 Bishop, CA 93515

Sixth Annual Colorectal Cancer Awareness Walk & Run
Saturday, March 25, 2023 @ Brown’s Town

ESCA
P.O. Box 1523
Bishop, CA 93515