The rd annual Seize the Day - Epilepsy Southwestern Ontario · 2019-05-28 · my friend my work my...
Transcript of The rd annual Seize the Day - Epilepsy Southwestern Ontario · 2019-05-28 · my friend my work my...
The 3rd annual
Seize the Day
Event DetailsI am running for
my parent
my grandpa
my school
my child
my uncle
my family
myself
my sibling
my aunt
my friend
my work
my grandma
my cousin
my community
anyone with epilepsyVollmer Culture and Recreation Complex
Sunday, September 22, 2019
Sunday, September 22, 2019
Fees
Location
5k Run / 2.5k Walk
To learn more, visitepilepsyswo.ca
Join Us for Windsor’s 3rd Annual Seize the Day!
The Seize the Day 2.5k Walk & 5k Run supports individuals, families and members of the community affected by seizures and epilepsy. Whether you are walking to honour someone who passed away from a seizure, supporting those affected by epilepsy and seizures, or want to help raise awareness, we invite you to join us for this special occasion. Whether you run marathons, or just enjoy the casual walk, everyone is welcome to participate! We hope you can join us and help make this annual event an impactful one.
• $20 in advance or $25 day of the event
• Collect $100 in pledges & your registration
fee will be waived
• Collect $150 in pledges & your fee is waived,
plus you will recieve a free run t-shirt
• BBQ Social following the run
Vollmer Culture and Recreation Complex, 2121 Laurier Pkwy, Windsor, ON N9J 0B4
Charitable Reg No. : 11890-0802-RR0001
Event start time: 10:30 a.m.
my grandchild
my spouse
my family member
Connect with [email protected] 519.890.6614Toll free 1.866.EPILEPSYwww.epilepsyswo.ca
Pled
ge F
orm
My
Pled
ge G
oal
Spon
sor's
N
ame
Spon
sor's
Add
ress
City
$To
tal A
mou
ntRe
ceiv
ed
Post
alC
ode
Am
ount
Pl
edge
d
Help
us
rais
e m
oney
to s
uppo
rt p
ublic
ed
ucat
ion
and
supp
ort p
rogr
ams
at
Epile
psy
Sout
hwes
tern
Ont
ario
.
For q
uest
ions
or m
ore
info
rmat
ion,
go
to
epile
psys
wo.
ca o
r cal
l us
at 5
19.4
33.4
073
Plea
se c
ompl
ete
your
ple
dge
form
, col
lect
yo
ur m
oney
and
dro
p of
f at E
SWO
. Ple
dges
$2
0 or
mor
e ar
e el
igib
le fo
r a ta
x re
ceip
t; m
ust
incl
ude
thei
r com
plet
e ad
dres
s to
rece
ive.
$
Regi
stra
tion
Form
Surn
ame
Sign
atur
e of
Par
ent /
Gua
rdia
n if
appl
ican
t is
unde
r 18
(Ple
ase
Prin
t Cle
arly
)
Firs
t Nam
e
Part
icip
ant’s
Sig
natu
re
Mal
e
Addr
ess
(incl
ude
Apt.
Num
ber/
R.R
. Num
ber)
City
Regi
stra
tion
fee
is $2
0 in
adv
ance
and
$25
if re
gist
erin
g on
the
day
of th
e ev
ent. T
he fe
e is
wai
ved
for t
hose
subm
ittin
g at
leas
t $10
0 on
race
day
. All c
hequ
es M
UST
be m
ade
paya
ble
to Ep
ileps
y So
uthw
este
rn O
ntar
io. R
egist
ratio
n fo
rm c
an b
e m
aile
d to
or d
ropp
ed o
ff at
Epile
psy
Sout
hwes
tern
Ont
ario
, 797
Yor
k St, U
nit 3
, Lon
don
ON,
N5W
6A8
. Cha
ritab
le R
eg. N
o. 118
90-0
802-
RR00
01. O
nlin
e re
gist
ratio
n ca
n be
com
plet
ed a
t ww
w.e
pile
psys
wo.
ca/s
eize
-the
-day
-lond
on/
Wai
ver: I
n co
nsid
erat
ion
of y
our a
ccep
tanc
e of
this
regi
stra
tion,
I her
eby
for m
ysel
f, my
heir,
exec
utor
s and
adm
inist
rato
rs w
aive
and
rele
ase
any
and
all r
ight
s an
d cl
aim
s for
dam
ages
I may
hav
e ag
ains
t Epi
leps
y So
uthw
este
rn O
ntar
io o
r Vol
lmer
Cul
ture
and
Rec
reat
ion
Com
plex
, thei
r rep
rese
ntat
ives
, suc
cess
ors,
and
assig
ns, o
r aga
inst
offi
cers
, dire
ctor
s, or
repr
esen
tativ
es o
f any
of t
he a
bove
for a
ny o
r all i
njur
ies s
uffe
red
by m
e in
Sei
ze th
e Da
y W
alk/
Run
, I al
so g
ive
perm
issio
n fo
r the
free
use
of m
y na
me
and/
or p
ictu
re in
any
bro
adca
st/te
leca
st o
r oth
er a
ccou
nt o
f thi
s eve
nt. I
furth
er a
ttest
and
cer
tify
that
I am
phy
sical
ly fi
t, and
hav
e su
ffici
ently
trai
ned
for p
artic
ipat
ion
in th
is ev
ent, a
nd m
y ph
ysic
al c
ondi
tion
has b
een
verifi
ed b
y a
licen
sed
med
ical
doc
tor.
Fem
ale
Prov
ince
Post
al C
ode
Phon
e N
umbe
r (in
clud
e Ar
ea C
ode)
The3rd
annu
al
Seiz
e th
e D
ay5k
Run
/ 2.
5k W
alk
Inst
ruct
ions Em
ail
Add
ress
CashCheque