Cliff Hanger 5K/8K Run and Walk
2010 Mail In Registration
Event (circle) 8K
5K Run
5K Walk
Name ____________________________________
Birth Date _____/______/________ Age on Race Day _______ Gender (circle) Male Female
Address ____________________________ City ___________________ State ________ Zip __________
Phone _________________________________ e-mail _________________________________________
Are you on a team? If so, team name _________________________________________________________
Team sponsor, if applicable _________________________________________________________________
Shirt Size (circle) Youth L Adult S M L XL for XXL (add $2)
Extra Breakfast(s) $5 each ___________ Join KC Track Club $15 _______________
Donation to Cliff Hanger Charity Neighbor To Neighbor $______________
Before October 27, $20 After October 27, $23 On Race Day $25
Total Amount Enclosed ________________________
WAIVER: I know that running and volunteering in running events are potentially hazardous activities. I assume all risk associated
with these activities. I hereby waive and release, for myself and anyone entitled to act on my behalf, the Kansas City Track Club,
the Road Runners of America, Gladstone School, Kansas City Parks and Recreation, Race Day Timing Solutions and all sponsors
and race officials from all claims of any kind arising out of my participation in this event.
Signature ____________________________________
Date____________
(Signature of parent of guardian if under 18)
Please use a separate form for each entrant.
Make checks payable to: Kansas City Track Club
Mail to: Kansas City Track Club, 6718 Vahalla Drive, Shawnee KS 66217