Entry Form is Ready

Participants can register on active.com or use a paper version and send it to me or to the Valley View Medical Center Cancer Center.  Here it is:

Breast Cancer Remembrance Walk/5K    Saturday October 4, 2014 @8:00 AM

$20.00 registration fee  _____    

5K _____    1 Mile Walk ______

Name ____________________________________________          Date of Birth______________

Address ___________________________________  Phone # _____________________

City  _________________________________              Zip  _______________________

Email _________________________________  

Unisex Small                                                                      Child    Medium

            Medium                                                                                Large                                       

            Large                                                                                      Extra Large

            X-Large

            XX-Large

Are you a breast cancer survivor?  Yes    No

Emergency Contact  _____________________  Phone #  _______________________________

Please return by September 27, 2014 to: Robyn Brown, 237 South 400 East, Cedar City, UT  84720

or Valley View Medical Center Cancer Center.