Payment Information

For the first 200 people registering and raising $25 for the Mental Health Awareness Run/Walk, receives a 2013 T-Shirt. Use the section below to complete the Payment Information. Credit Cards will be charged $25.00 by filling the form out below. Make Checks Payable to New Horizons of the Treasure Coast and Okeechobee. If paying with paypal, you will need to finalize your payment on the following page.

Signature for Assumption of Risk, Release, and Permission (Required)

In consideration of my voluntary participation in the Mental Health Awareness Run/Walk, I hereby expressly assume all risks of personal injury, death, or property loss arising in any way out of my participation. I represent that I am physically fit and able to participate in this event. I hereby release and agree not to sue New Horizons of the Treasure Coast and Okeechobee, their respective officers, directors, volunteers, employees, sponsors, and agents from, or in connection with, any and all liability and claims arising out of my participation in this event. I grant full permission to the organizers of this event to use and publish my name and image as a participant in photographs, videos, or other recordings.