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Registration – 2nd Annual Dorothy’s Family 2 mile Run/Walk Sunday, September 28th, 9 a.m. Location: Benedictine University 5700 College Road Lisle, IL 60532 Proceeds to benefit Central DuPage Hospital’s Pediatric Oncology Ward in loving memory of Dorothy Traver
Name:________________________________Address:___________________________ City:____________________ State: ____ Zip:_________________ Email:_______________________ T-shirt Size: XL___ L___ M___ S____ (size not guaranteed) Waiver: (Must be signed for entry) In consideration of acceptance of this entry, I hereby for myself, my heirs, successors, assigns, executors and administrators, irrevocably waive any and all rights and claims for damages, in law or equity, I may have against Benedictine University, Benet Academy, Dorothy’s Family, all event organizers and sponsors, all individuals associated with the event, their representatives, successors, assigns, employees, insurers, affiliates and students for any and all injuries suffered by me in connection with said event, including pre and post race activities. I further declare that I am in good health to participate in this event and I attest and verify that I am physically fit and have sufficiently trained for this event. I hereby agree that Dorothy’s Family and its organizers may use any photographs and/or video of the event, including pictures of all event participants for promotional purposes, with further approval or consideration. Signature:________________________________ Date:_______________________ Signature of Parent/Guardian (if necessary):_____________________Date:_________ Visit us on the Web: www.dorothysfamily.org
Questions? Please call Tim Traver at (312) 363-8875
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Send mail to
ericmayer@dorothysfamily.org with questions or comments about this web site.
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