Who We Are
Compassion and Justice
Developing Leaders / ITI
International Training Institute
ITI: NEXT STEPS
2015 Safari run
2015 Safari walk/run registration form
60 & above
Emergency Contact Name
Emergency Contact Phone
RACE ENTRY FEE (thru Aug 21)
Kids (newborn-9) $5
Method of Payment
Online - Network Beyond
Online - PayPal
Check Mailed to Network Beyond
When you click SUBMIT below, you will be re-directed to the page where you can pay online or get mailing information.
Adults (18 & up):
hereby give permission for the leaders, employees, volunteers, or agents of this event to seek and secure any needed medical attention or treatment, including hospitalization, if necessary, as a result of injury or illness during the Safari 2K/5K/10K Walk/Run. In doing so,
I agree to pay all fees and costs arising from this action to obtain medical treatment. I give
permission for attending physician(s) and other medical personnel to administer any needed
medical treatment, including surgery, and I agree to pay for the medical treatment.
I agree to indemnify and hold harmless all sponsoring organizations and its leaders, employees, volunteers, or agents and the City of Greeley from any and all claims arising from participation in this event, or as a result of injury or illness during this event.
I understand that by entering my name in this box, I am agreeing to the conditions stated above.
Children (17 & younger):
I hereby give permission for the child named below to participate in the Safari 2K/5K/10K Walk/Run, and by entering my name on this form, I am agreeing to the conditions stated above.
Parent or Guardian's Name
is a 501(c)3 non-profit based in Greeley, Colorado, that resources the transformation of people and communities.
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