Saturday, September 19th, 2015 at 10am

Start/Finish located at Crow’s Feet Commons:

875 NW Brooks Street, Bend, OR 97701

Race Information:

  • Registration Fee: $20/without T-Shirt, $30/with T-Shirt
  • NEW THIS YEAR: Discounted registration for groups/teams
  • 25% off for groups
  • 50% off for mental health consumers
  • All proceeds benefit Central Oregon’s National Alliance on Mental Illness (NAMI)
  • USATF sanctioned event
  • 5k course begins and ends at Crow’s Feet Commons. The course will wind through beautiful neighborhoods in west Bend.
  • Course time limit of 2 hours
  • Water and snacks will be provided on race day
  • Live music and raffle prizes will be presented after the race
  • Post-race education and outreach provided by top mental health providers in Central Oregon.
  • BACK BY POPULAR DEMAND: Prizes for “Biggest Team”

Registration and Packet Pick-up Information:

  • Register in person at Foot Zone. Entry-fee checks can be made out to NAMI Central Oregon 5K run/walk.
  • Mail-in registration form to:

Anne Pendygraft

Attn: NAMI 5K

20370 Poe Sholes Drive

Bend OR 97701

  • Register on-line at:

or

recovery5k.wordpress.com or namicentraloregon.org

Additional information: Contact Anne Pendygraft:

or Roger Olson: 541-480-1960

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Please send in this portion with your check.

Mail Entry Form to:

Anne Pendygraft

Attn: NAMI 5K

20370 Poe Sholes Drive

Bend OR 97701

Make checks payable to:

NAMI Central Oregon 5K Run/Walk

NAME: ______AGE: _____ SEX: ____ PHONE: ______

ADDRESS: ______CITY: ______STATE: ____ ZIP______

Check one RUN: _____ WALKER: ______

Email Address ______

Adult Shirt Size ____ Small ____ Medium ___ Large ____ XLarge____ XXLarge

Participating as a team______Yes_____No

Team Name:

Waiver:

I understand that running or walking in NAMI Road to Recovery event is a potentially hazardous activity. I attest that I am physically fit, have sufficiently trained for participation in this event, and have not been advised against participation by a qualified health professional. In consideration of accepting my application, I, for myself and anyone entitled to act on my behalf, waive, release, and discharge from any and all claims or liabilities of any kind which arise out of or relate to my participation in this event, and I indemnify and hold harmless any and all sponsors including but not limited to NAMI, Telecare Corporation, the organizers, and representatives, officers, agents, and successors from all claims or liabilities of any kind made, waived, released, or discharged herein, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I understand that my name and or photo may be used for promotional purposes.

______

Signature (Parent’s Signature If under 18)

______

Date