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Show I MENTAL HEALTH MOUTH I May 4, 1991 RUM FOE? YOUR HEALTH Coordinated by DeBoer's Running Store 5K Fun Run Jt $6 Pre-Registration J( iV J $7 Day of Race i )W' (Includes T-Shirt) J Sponsored By: Benchmark Regional Hospital Davis County School District The Davis County Clipper : Davis County Sheriff's Department Wheels, Etc. ; McDonalds i DeBoer's Running Store 5-Points Mall : i ! hjMonlrfojmjttonteh 1299-5300 O RUN FOR YOUR HEALTH Please indicate event and enclose check diic uilc ln consideration of your acceptance of this registration, I hereby for myself. DlKfc HIKb my heirs, executors and administrators, waive any and all rights and claims for damages I may have against the sponsors, coordination groups, and any M A K I CT DUHMC individual associated with the event, their representatives, successors and IMAIVI t r HI )lIr assigns for any and all injuries suffered by me in connection with said event. Also, none oi the above are responsible lor the loss of personal items nor CTDCCT any other form of aggravation in connection with said event. I have been 1 1 1 warned that I must Be in good health to participate in this event I also have w rrATr m given permission for the use of my name and picture in any broadcast, 01 I Y , h IAI b ZIP telecast or print media account of this event. In filling out this form I acknowledge that I have read and fully understand my own liability and do AGE SEX MALE FEMALE accept me res.nct.ons. Signature Send to: Benchmark Regional Hospital Parent must sign if participant is under age 18) 592 West 1350 South REGISTRATION IS NOT ACCEPTABLE UNLESS Woods Cross, Utah 84087 DISCLAIMER IS SIGNED jiphi i tnn i n ii in n mi ii ii n 1 1 mi in i i n ii i tit n ii 1 1 1 ti i titi i m n urn n n m i m ii tin inni tn urn i i 1 1 m tn i m mi mi mil i n n n i ti mi i itn i r 1 1 n in ti m 1111 urn im tnininn iiihi in tiik: . y ijiiit lit iiiiit f lit lit iiiiiit lit iiitiit iitiit ritf lit lit iff tit iiit iif iiitiirtiiiiit lit iviiti titj z I ! l r ith 1 j I i'w v hmiin ins J j jf1"" v f", i By the time Diane Peterson came to see f ''V-. 5 Dr. Heiny, she had been sick off and on for 5 I I three months with sinus problems. The doctor examined her, then told her that a skiing III accident she described had done more damage I : 1 can sne nat tnougnt- e tQld her that, in fact, I f ' I it had broken her nose. I I Diane was admitted for surgery the S I I nextday, and although the operation was a little I I more complicated than anticipated, it went I j "I thought that this whole thing was going I I to be painful, but it wasn't," says Diane. "They I 1 I took such good care of me that it didn't bother S 1 I me. And Dr. Heiny was great." 1 1 Diane's husband was out of town at the time 1 1 I 5 of surgery and kept in close contact with Dr. S I 1 Heiny by phone. So did a family friend. 1 1 "They both said that he was so wonderful 1 4r to them on the phone. He told them everything 5 , 'J that was going on, and was really cordial." Diane has been back on the job as a flight I 5 attendant for quite some time now. And she's S I skiing "very carefully." E I E r 1 1 1 I Dr. Bernard A. Heiny is an If I I Ear, Nose and Throat E i I I specialist, and an active I l l memroourmecstaf. I If x I Practce 15 Seated at S j I i 1 1 . I MeJical Drive in I I I I Bountiful. For an appointment, I I I Li .LJt please call 295-5581. j I ! Lakeview Hospital ! j J I 630 East Medical Drive - Bountiful, Utah 84010 299-2504 I I E 1 I niiim iiihiii ii imiiniHiiHiiiiHiHiH i , p I I I I in 11 i i minimi iiimmMH hm " ' ' mi"" ' 1 1 "iiiiiiiiiiiiiiii ,, , M |