When

Saturday, April 13, 2019 from 8:00 AM to 12:00 PM PDT
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Where

Visalia Medical Clinic (East parking lot)

5400 W. Hillsdale Avenue
Visalia, CA 93291

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VMC's Fifth Annual Dr. James Mohs Memorial Diabetes Walk

VMC is hosting its 3K/5K diabetes walk and a kids group walk. Registrants receive a FREE commemorative shirt while supplies last. • Health vendors • Diabetes/health info • Blood pressure/sugar checks • Central California Blood Center • Raffle prizes • Meet physicians and staff Info: Susan Smith, PhD, CDE @ ssmith@vmchealth.com or 739-2087.

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Release of Liability

  • RELEASE OF LIABILITY REGISTRATION STATEMENT: In consideration of Visalia Medical Clinic, (hereafter referred to as VMC) granting the participant permission to take part in activities/programs, I hereby assume all risks of personal injury (including death) and property damage that may result from participating in any activity or program. I do hereby release and agree to indemnify, defend, and hold harmless VMC, including its agents, servants, employees, officers, directors and shareholders from all liability, including claims and suits at law or in equity, for damages or injuries, fatal or otherwise, which may result from any negligence or the participant taking part in activities/programs offered by VMC at any location that these activities may take place. I agree to use any and all equipment as it was intended and not modify it in any way which could increase chances of failure or harm in any way.

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    I attest that I have read the Release of Liability Registration Statement and agree to its terms.

  • CONSENT TO PHOTOGRAPH & AUTHORIZATION FOR USE OR DISCLOSURE: I hereby consent to be photographed while participating in activities/programs offered by VMC. The term “Photograph” includes video or still photography, in digital or any other format, and any other means of recording or reproducing images and/or audio. I hereby authorize the use of the photograph(s)/Video by, or disclosure of same to VMC for promotion or any other purpose. By checking the box I attest that I have read the consent to Photograph & Authorization for Use or Disclosure.

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    I attest that I have read the Consent to Photograph & Authorization For Use or Disclosure.

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