Citizens United for Research in Epilepsy

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Field Is Required Please select an amount. For gifts over $2,500, please call the Development team at 312-255-1801.

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In consideration of acceptance of this entry, I waive any and all claims for myself and my heirs against officials and sponsors of this event for illness or injury which may result directly from my participation. I further state that I am in proper physical condition to participate in this event. I also give permission for the use of my name and/or picture in any public account of this event. No refunds will be issued.

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