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2025 Registration
5k Run
Select this option to register for the 5k Run.
$
10
2.5k Walk
Select this option to register for the 2.5k Walk.
$
5
Donation
Just interested in making a donation to Employee Wellness? We appreciate you — thank you!
$
10
$10
$5
$1
Limited Edition Items
Sweatband
Beat the heat (and competition) with these limited edition sweatbands!
$
5
Quantity
1
2
3
4
5
6
7
8
9
10
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Name
*
First Name
Last Name
Email
*
example@example.com
Category
Please Select
Men's 5k Run
Women's 5k Run
Team 5k Run
Age Group
Please Select
19/under
20–29
30–39
40–49
50–59
60+
Team Name
This helps us group your registration!
Are you an Ivinson employee?
*
Yes
No
Department
Please Select
Accounting
Administration
Admitting
Audiology
Behavioral Health
Cancer Center
Cardiac Rehab
Cardio Pulmonary Services
Care Transition
Case Management
Clinical Engineering
Compliance
Diabetes Clinic
Dialysis
Dietary
Emergency Department
Engineering
Environmental Services
Family Care Unit
Foundation
Guest Relations
Health Info Management
Hospitalist
House Supervisors
Human Resources
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Ivinson Medical Group
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Marketing
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Medical Staff Office
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Address
Street Address
Street Address Line 2
City
Please Select
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Acknowledgement
*
I hereby do declare that my physical condition is adequate to participate in the Run For Your Life 5k Fun Run/2k Walk. I, the undersigned, waive any and all rights and claims for damages I may have against Ivinson Memorial Hospital and their representatives for any injuries suffered by me in said event.
Signature
*
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