Waiver/ReleaseIn consideration of being accepted in the Family Fun Walk/Run, I for myself, and as authorized on behalf of each and every member of my team, my heirs, my executors, administrators and assigns do hereby expressly release and discharge the Hunterdon Medical Center, Hunterdon Health and Wellness Center, Radom & Wetter, the organizers directors, sponsors, volunteers, its officers, agents, and employees from any and all claims, demands and actions or judgments of any kind arising, in whole or in part, out of participation in this event. I also give my permission for the use of my name and/or picture in any newspaper, broadcast, telecast or other account of this event.

Signature __________________________________________________________________ Date ____________________

Parent Signature (if athlete is under age 18) _______________________________________    Date ____________________

Hunterdon Health & Wellness Centersof Clinton and Whitehouse Station

Hunterdon Regional Cancer CenterFox Chase Cancer Center Partner

FAMILY FUN WALK/RUNSaturday, May 9, 2015

To benefit Hunterdon Regional Breast Cancer Program

FILL OUT & SEND IN TO REGISTER

Start a team & become a Team Captain Name the Team Join an existing team Team’s Name Join as an Individual T-shirt Size for 5K & 2 Mile Walkers only (circle) Small Med Large XL Name Phone NumberStreet Address

(City, State, Zip)E-mail Address Gender (circle) M F Date of Birth 5k Run   2 Mile Walk  Mad Dash Registration Fee $  Credit Card (circle one) VISA MC AMEX DISCOVER Card Number Exp. Date Signature Check (made payable to “HH Foundation”)

DUKE ISLAND PARK • Old York Road, Bridgewater TownshipSomerset County (USATF Certified Course)SAME DAY REGISTRATION & RACE CHECK-IN BEGINS AT 8 AM 5k Run begins at 9 am 2 Mile Walk begins at 9:05 am - PETS WELCOME! Mad Dash for Children (FREE) begins at 9:45 amFEE: $20 Pre-registration / $25 on Race DayWe encourage a fundraising minimum of $100 per participant.

To Register ON-LINE or for more information on Family Fun Walk/Runvisit us on the web at http://familyfunrun.kintera.org

Questions? Please call 908-707-1500 (Radom & Wetter)908-735-6884 (Hunterdon Health & Wellness at Clinton)908-534-7600 (Hunterdon Health & Wellness at Whitehouse)

Exciting Raffle Prizes, 50/50 Cash Raffle, & giveaways to all participants! T-SHIRTS TO 5K RUN & 2 MILE WALK PARTICIPANTS ONLY (while supplies last)

SPONSORED BY:

TO BENEFIT:

Mail Registration to: HH Foundation Events Office • 2100 Wescott Drive • Flemington NJ 08822

RAFFLETICKET

RAFFLE PRIZES INCLUDE:52” HD TV • Lunch Cruise • Kindle Fire

“Weekend in the Fall” Maine TripHunterdon Health & Wellness CenterFull Year Membership (either location)

$200 ShopRite Gift Card • ipad10 Massages from HHWC (either location)

Golf Foursome at Beaver Brook CC

ENTER OUR 50/50

FOR

TIC

KET

S C

ALL

90

8.78

8.64

21O

NLY

$10

EA

CH

Your full circle of care.Hunterdon HealthcareHunterdon Healthcare Foundation2100 Wescott DriveFlemington, NJ 08822

ProudlySponsored by: Hunterdon Health & Wellness Centers

of Clinton and Whitehouse Station

FAMILY FUN WALK / RUN

Join us in the fight against

Breast Cancer. Join us for the...

Saturday - May 9th, 2015 5K Run - 2 mile walk

http://familyfunrun.kintera.org

Run to fight against Breast Cancer

Nonprofit Org.US Postage

PAIDFlemington, NJPermit No.172