16th Annual Savoy Cancer Center Breast Cancer Awareness Walk

Please fill out the form below to register for the Cancer Walk or to purchase a t-shirt. The registration deadline is October 4, 2024.

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Birthdate

Choose One: *

Participant w/ T Shirt – $20.00
Cancer Survivor – $0.00
T Shirt Only – $20.00
Adult 2XL-5XL Shirt – $25.00

Cancer survivors receive a free t-shirt.

Shirt Size *

T-shirts will be available for pick up at Savoy Cancer Center on Friday, October 11, 2024 from 11 am – 2 pm.

WAIVER

Each participant must read and acknowledge.

– As a participant in the “Savoy Breast Cancer Awareness Walk 1 mile fun run/walk”, I, for myself, my executor, administrators, and assigns, do hereby release and discharge Savoy Indigent Patient Support, Savoy Cancer Center, the town of Mamou, the event site, their management, their officers, members, sponsors, organizers, or their representatives, or their successors, and all cooperating businesses and organizations from all claims of damages, demands, actions, and causes whatsoever, in any manner arising or growing out of my participation or that of my child in this event.

– I give my full permission for the use of my name and photograph in this event. I also give my full permission for such first aid as is deemed necessary to be provided to me or my child on the premises or prior to transport to a hospital for further treatment.

Click here to agree to the waiver. *

I agree.

Total Amount

$0.00

PayPal Commerce *

Card Number

Expiration Date

Security Code

Card Holder Name

Email *