Promise for the Cure

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					                          MAK E AN IMPACT. | Apr il 28, 201 2
                                                                                                                                                  komenozark.org
                                                                                                                                                    register online at:
  GLOBAL M SSION L CAL IMP
Promise Ifor .theo Cure. A C T .
                                                                                                                                     Carol Johnston & Mike Turner         honorary Chairs
                                                                                                                                 Allison Van Matre & Casey Cowan          Co-Chairs
                                                                                                                                                   Cortney Carlson        2012 race Chair
                                                                                                                                              rOGerS, ArkANSAS
                                                                                                                                   pINNACLe hILLS prOMeNAde
                                                                                                                                  sAturDAy, APriL 28, 2012
                                                                                                                                       M AKE AN IM PACT. | Apri l 2 8, 2 012
                                                                                                                                L o C A L I M P A C T.         G L O B A L M I S S I O N.
                    NEW FASTER COURSE!
10K race
Join us again this year for our 10K course sponsored
by Caltrate. The course is certified by USATF and each
participant will be timed and receive a commemorative
medal. Awards will be given to the top three place
survivors, male and female participants.
Competitive 5K race
The competitive event features a 5K course certified
by the USAFT. This year we are excited to include
chip-timing in your registration fee. The first-place
male, female, and survivor will receive roundtrip air
transportation on American Airlines or American Eagle
to any destination in the contiguous United States.
Limit one (1) ticket per household.
This race is sponsored by Dean foods.
family fun Walk                                                                                                                 Pasta Party
Not up for the full 5K? Join us for the Family Fun Walk 1K    teens for the Cure ®                                              The Washington regional sponsored 2012 Susan G.
course through Pinnacle Hills Promenade Mall sponsored        This is a wonderful way for schools in our community              Komen Pasta Party has undergone a transformation. Not
by Johnson and Johnson. Bring the whole family and            to show their support by putting together a team of               only has our venue changed, Pratt Barn of Pratt Inn &
enjoy a more leisurely pace while continuing to make an       students to walk, run, cheer or volunteer. Any school or          Barn, Fayetteville, AR but so has our menu. Following our
impact against breast cancer.                                 organization that is interested in this philanthropic venue       theme this year - Global Mission….. Local Impact
                                                              should contact our office at 479-750-7465 to receive a            we are having a “Taste of Italy” menu. Several local
                                                              packet of information. You will receive a specially               restaurants will be providing “tastings” of appetizers,
Bark for the Cure ®                                           designed Teens for the Cure t-shirt. Teens for the Cure is        salads, entrée’s and desserts. There will be beverages,
Bring your dog to PetSmart at Pinnacle Hills Promenade        sponsored by Academy sports.                                      entertainment and lots of ambience. This year’s event
Mall for the Komen Ozark Bark for the Cure sponsored                                                                            will be Friday, April 27th from 6:00pm – 9:00pm. Event
by milk-Bone. Walk your best friend through the 1K route                                                                        tickets are $25.00 per person. Children under 6 eat free.
with a water stop at the end. Prizes will be given in         Kids for the Cure ®                                               You can purchase tickets online at komenozark.org or at     Volunteers
various categories throughout the event. Full details and     Kids 12 and under, along with their parents, are invited          the door the night of the event.                            New and returning volunteers are encouraged to get
special rules can be found on our website.                    to join in the fun of the post-race party at Kids for the                                                                     involved. Race volunteers will receive a t-shirt courtesy
                                                              Cure ®. Founding sponsor Willard & Pat Walker                                                                                 of Georgia-Pacific, the maker of Quilted
                                                              Charitable foundation, inc. and Presenting Sponsor                survivor Breakfast                                          Northern and Vanity fair in appreciation
sleep in for the Cure ®                                       Kimberly-Clark invite you to this kid-friendly area               NEW THIS YEAR is our drop in survivor breakfast.            of their efforts. Georgia-Pacific is the
Not a morning person? Out of town on Race day? Reg-           featuring food, fun, and our Kid’s Dash sponsored by              Breast cancer survivors and one guest are invited to        National Series sponsor of the Volunteer
ister for our Sleep In for the Cure ® program sponsored       Kraft foods. Kids will receive a special and uniquely             stop by our Survivor Reunion Breakfast sponsored by         Recognition Program. For information
by hank’s & more fine furniture. Registration includes a      designed Kids for the Cure ® t-shirt. The first 2,000 kids        Walmart/sam’s Club. Join us at your leisure in the Food     about volunteer opportunities, please visit
special Sleep In for the Cure ® t-shirt mailed to your home   on Race day will receive a Kids for the Cure ® race medal         Pavilion between 7:00 and 9:00 am. The survivor parade      our website atkomenozark.org
prior to the race, if registered by April 13, 2012.           sponsored by Pepperidge farm. Parental supervision is required.   and photo will start at the Food Pavilion at 7:45 am.       or visit volunteer.uark.edu.
                                                                                                                          G L O B A L M I S S I O N.                                         L o C A L I M P A C T.
Komen ozark race for the Cure
The Ozark Affiliate of Susan G. Komen for the Cure is
all about keeping our PROMISE in our 10 county service
area. This area includes Benton, Boone, Carroll, Crawford,
Madison, Newton, Sebastian and Washington Counties
in Arkansas and Stone and Taney Counties in Missouri.
We join more than 2.5 million breast cancer survivors
and activists around the globe as part of the world’s
largest and most progressive grassroots network fighting
breast cancer. The Komen Ozark Race for the Cure is our
signature event and helps us raise awareness and funds                          About Susan G. Komen for the Cure
that support our Promise: to save lives and end breast                          Nancy G. Brinker promised her dying sister,
cancer forever by empowering people, ensuring quality                           Susan G. Komen, she would do everything in her
care for all and energizing science to find the cures.                          power to end breast cancer forever. In 1982,
                                                                                that promise became Susan G. Komen for
                                                                                the Cure, now the world’s largest breast
Date                                                                            cancer organization and the largest
Saturday April 28, 2012                                                         source of nonprofit funds dedicated
Location                                                                        to the fight against breast
                                                                                cancer with more than $1.9
Pinnacle Hills Promenade Mall, Rogers, AR
                                                                                billion invested to date. For
Ways to register                                                                more information about
• Register online at komenozark.org                                             Susan G. Komen for the Cure,
• Register by mail by detaching the entry form on this                          breast health or breast cancer, visit
  brochure.                                                                     komen.org or call 1-877 GO KOMEN.
• Register on-site at the following locations and times
        • Pinnacle Hills Promenade in Rogers, AR
          April 11-27 from 10am-6pm Monday-Saturday                                                        is Komen’s rallying cry,
          & 1pm-5pm Sundays                                                     encouraging women to take an active role in their breast
                                                                                health—to become educated about breast cancer and
              registration office opens 6am, race Day.
                                                                                understand that being aware is the first step in the
                                                                                process. Listen for the cheers as you walk or run the
              • Fayetteville Mall in Fayetteville AR                            Race and join in!
                April 14th and 15th and April 20th and 21st
                from 10am-6pm on Saturday
                & 1pm-5pm on Sundays                                            Our Promise
                                                                                Our Promise is to save lives and end breast cancer
• Race packets may be picked up at either registration office,                  forever by empowering people, ensuring quality care for
except for the Competitive 5K and 10K packets which are only                    all and energizing science to find the cures.
available at the Pinnacle Hills Promenade Mall.
                                                                                survivors are the stars of Komen race for the Cure
teams                                                                           and an inspiration to us all. Breast cancer survivors
Teams are welcome on Race day. Team registrations must                          who wish to be recognized may pick up their
be submitted together through your captain. Online                              complimentary pink cap and pink t-shirt provided by
registration of all teams is encouraged at komenozark.org
                                                                                Zeta tau Alpha.
or call 479-750-7465 for more information. Every team
registered online allows more money to go toward our
mission. Online early bird registration closes on April 17,                     ‘In Celebration Of’ &
2012. If you are putting together a team and not
                                                                                ‘In Memory Of’ Back Signs
registering online, you will need to drop these team
packets off on March 29-30, 2012 from 10-5 at the                                            Participants are also invited to recognize
registration location at the Pinnacle Hills Promenade Mall.                                  those special people who have been
Please check our website for more detailed information or                                    touched by breast cancer. “In Memory of”
contact komenozark.org.                                                                      and “In Celebration of” back signs are
                                                                                available for all Race participants. The Breast Cancer
The Running Ribbon is a registered trademark of Susan G. Komen for the Cure ®   Survivor Recognition Program is sponsored by
Brochure Design Provided by 5 Star Sports                                       Zeta tau Alpha and Bank of America.




                                                                                oNe eNtry Per PersoN                                                                                                                                          PhotoGrAPhiC AND resuLts reLeAse and WAiVer AND reLeAse of CLAims
                                                                                                                                                                                                                                              i agree that any and all representations made and releases, waivers, covenants, consents and permissions given
                                                                                BEFORE GETTING STARTED...                                                                                                                                     by me hereunder are given on behalf of me and any and all of my minor children or persons over whom i have
                                                                                • For fast and secure processing, you                                                                                                                         guardianship participating in or attending the event.
                                                                                  may register online at komenozark.org.

                                         VISIT                                  • Please print clearly and complete all sections.
                                                                                • Each form must be signed
                                                                                                                                                                                                                                              I give my consent and permission to The Susan G. Komen Breast Cancer Foundation, Inc. d/b/a Susan G. Komen for
                                                                                                                                                                                                                                              the Cure (“Komen”), its affiliates and races, their sponsors and corporate sponsors, their successors, licensees, and
       www.komenozark.org                                                       • Team entries of 10 or more must be submitted in one                                                                                                         assigns the irrevocable right to use, for any purpose whatsoever and without compensation, (i) any photographs,
                                                                                                                                                                                                                                              videotapes, audiotapes, or other recordings of me that are made during the course of this event (the “Event”); and (ii)
                                                                                  envelope no later than April 6, 2012 for early packet
             TO VIEW                                                              pick-up.
                                                                                                                                                                                                                                              the results of my participation in this Event (e.g., race time, name, participant number).

          COURSE MAPS                                                           TYPE OF ENTRY
                                                                                                                                                                                                                                              I understand that (i) my consent to these provisions is given in consideration for being permitted to participate in this
                                                                                                                                                                                                                                              Event; (ii) I may be removed from this competition if I do not follow all the rules of this Event; and (iii) I am a voluntary
      OF THE 5K & 10K RACES!                                                       Individual     Team                                                                                                                                      participant in this Event. I am in good physical condition and am solely responsible for my personal health, safety
                                                                                                                                                                                                                                              and personal property. i know that this event is a potentially hazardous activity and i hereby voluntarily assume full
                                                                                Team Name:
     USATF CERTIFIED RACE COURSE - 5K - AR12003DLP                                                                                                                                                                                            and complete responsibility for, and the risk of, any injury or accident thAt may occur during my participation in
     USATF CERTIFIED RACE COURSE - 10K - AR12002DLP                                                                                                                                                                                           this event (iNCLuDiNG, But Not LimiteD to, my fuNDrAisiNG ACtiVities associated with the event) or while
                                                                                BreAst CANCer surViVor?                                                                                                                                       on the eVeNt premises (CoLLeCtiVeLy, “my PArtiCiPAtioN”). to the fuLLest exteNt of the LAW, i, for
                                                                                   Yes, I would like to be recognized by receiving                                                                                                           myself, my next of kin, my heirs, administrators, and executors (CoLLeCtiVeLy, “reLeAsors”), hereby release and
                                                                                                                                             ENTRY CATEGORY
                                                                                    a pink t-shirt and hat                                                                                                                                    hold harmless and covenant not to file suit against (i) KomeN, [AffiLiAte CorPorAte NAme] D/B/A [AffiLiAte
DIRECTIONS                                                                                                                                      Timed 10K Race                                                                   $30.00      DBA NAme] AND ALL other KomeN Affiliates and their resPeCtiVe DireCtors, offiCers, VoLuNteers,
Participants are encouraged to review primary and
                                                                                PARTICIPANT                                                     Competitive 5K Run - timed                                                       $25.00      AGeNts AND emPLoyees; (ii) any event sponsors; and (iii) all other persons or entities associated with this event
alternative routes, carpool and arrive EARLY. Lane closures
on the Race course begin at 7 AM and this will slow traffic                                                                                     Regular 5K - non-timed                                                           $20.00      (collectively, the “releasees”) for any injury or damages i might suffer in connection with my participation. this
into the venue.                                                                 First:                     MI:      Last:                                                                                                                     release applies to any and all loss, liability, or claims i or my reLeAsors may have arising out of my participation,
                                                                                                                                                1 Mile Family Fun Walk                                                           $20.00      including but not limited to, personal injury or damage suffered by me or others, whether such losses, liabilities,
PRIMARY ROUTES                                                                                                                                  Teens for the Cure                                                               $10.00      or claims be caused by falls, contact with and/or the actions of other participants, contact with fixed or non-fixed
Traveling north on I-540, take exit 82 and turn right off next                  Email Address:
                                                                                                                                                Kids for the Cure - ages 12 & under                                              $10.00      objects, contact with animals, conditions of the eVeNt premises, negligence of the releasees, risks not known to
exit. Proceed to the Pinnacle Hills Promenade Mall and turn
left on Promenade Boulevard. Traveling south on I-540, take                     Address:                                                                                                                                                      me or not reasonably foreseeable at this time, or otherwise. i understand that i am solely responsible and liable for
                                                                                                                                                Bark for the Cure                                                                $20.00
exit 83 and turn left off the exit, then turn left on New Hope                                                                                                                                                                                all aspects of my fundraising activities associated with my participation, including, but not limited to, the safe and
Road. Turn right on Promenade Boulevard.                                                                                                        Sleep In for the Cure                                                            $25.00      lawful conduct of any fundraising activities.
                                                                                City:                      State:           Zip:
                                                                                                                                                Team Delivery                                                                    $50.00
ALTERNATE ROUTES                                                                                                                                                                                                                              [[Note: the following language shall only be included in the waiver if the event is held in California: this release
Traveling north on I-540, take exit 81 and turn right off the                   Home Phone: (        )               -                          Pasta Party - Friday, April 27                             Qty______X $25.00
exit. Continue on Pleasant Grove Road and then turn left on                                                                                                                                                                                   extends to claims and facts unknown and unsuspected to exist at the time of executing this release. All rights under
                                                                                                                                                Have T-Shirt Mailed to You                                 Qty______X $5.00/shirt            section 1542 of the California Civil Code are hereby expressly waived with respect to any of the claims, injuries, or
Dixieland Road. Turn left on New Hope Road, then turn left                      Age as of April 28, 2012
on Bellview Road. Traveling south on I-540, take exit 85 and                                                                                    Pink Postcard Tribute                                                            $5.00       damages described in this release. section 1542 of the California Civil Code reads as follows:
turn left off the exit. Continue on Walnut Street and then turn                 Gender:      F      M                                         Add a tax deductible donation                                                      $_____      A GeNerAL reLeAse Does Not exteND to CLAims WhiCh the CreDitor Does Not KNoW or susPeCt
right on Dixieland Road. Turn right on New Hope Road, then                                                                                                                                                                                    to exist iN his fAVor At the time of exeCutiNG the reLeAse, WhiCh if KNoWN By him must hAVe
turn left on Promenade Boulevard.                                                                                                            TOTAL AMOUNT ENCLOSED                                                                $_____
                                                                                 T-shirt size (Circle One): Adult: S M L XL 2XL 3XL                                                                                                           mAteriALLy AffeCteD his settLemeNt With the DeBtor.]
                                                                                                                                             rACeDAy reGistrAtioN Costs AN ADDitioNAL $10 Per CAteGory                                        This Photographic and Results Release and Waiver and Release of Claims (collectively, the “Release”) shall be
SAFETY
For the safety of all participants, rollerblades and pets are                                    Youth: S (6-8)     LG (14-16)                                                                                                                construed under the laws of the state in which the Event is held. In the event any provision of this Release is deemed
discouraged from participating in this event. Thank you for                                                                                   PiNK PostCArD triBute                                                                           unenforceable by law, (i) Komen shall have the right to modify such provision to the extent necessary to be deemed
                                                                                                                                              A personalized postcard stating that you participated in the Komen Ozark
your cooperation.                                                               T-SHIRTS WILL BE DISTRIBUTED ON A FIRST COME, FIRST SERVED    Race for the Cure® in celebration of a breast cancer survivor or in memory of                   enforceable; and (ii) all other provisions of this Release shall remain in full force and effect.
RACE DAY SCHEDULE                                                               BASIS, AND UPON SIZE AVAILABILITY. ONLY THOSE 12 YEARS OF     someone special will be mailed. Please clearly print the name and complete
                                                                                                                                              address of the person you wish to receive the postcard and the name of the
7 - 9 AM - Drop in Survivor Breakfast (Food Pavilion)
                                                                                AGE OR YOUNGER WILL RECEIVE A KIDS FOR THE CURE T-SHIRT.
                                                                                                                                              person you are honoring or remembering on the form that follows. Please
                                                                                                                                                                                                                                              I understand that I have given up substantial rights by signing this Release, and have signed it freely and voluntarily
7:30 AM - 10K start                                                                                                                           include a $5 donation for EACH postcard.                                                        without any inducement, assurance or guarantee being made to me and intend my signature to be a complete and
7:45 AM - Survivor Photo & Survivor Parade to Start                                                                                           my NAme__________________________PhoNe #_____________________                                   unconditional release of liability to the greatest extent allowed by law.
8:00 AM - Competitive 5K run                                                                                                                  PLeAse seND PostCArD to:
8:30 AM - Non-timed 5K run                                                        PAymeNt:                                                    NAme__________________________________________________________                                  Signature of participant (parent/Guardian, if under 18)                                                  date
8:30 AM - Bark for the Cure (PetSmart)
                                                                                  ______CheCK ______CAsh ______ComP                           ADDress_______________________________________________________
9:00 AM - 1 Mile Family Fun Walk
9:30 AM - Stage Presentations                                                     CC#________________________exP. DAte________                City_____________________________stAte______ZiP________________

10:00 AM - Kids’ Dash (age 5 and under)                                                                                                       For EACH postcard, please enclose $5.00 (check or money order). For more than one card,
                                                                                                                                                                                                                                              Signature (parent/Guardian, if under 18)                                                                 date
                                                                                                                                              please enclose a separate sheet with additional names and addresses. Postcards will be mailed
                                                                                                                                              after the Race. Include amount due on “Entry Form”.
CANCELLATION STATEMENT
This event will occur rain or shine. We reserve the right to
cancel in extreme circumstances. In that event, there will be
no refunds, rather, your entry fee will be used as a donation                   reGistrAtioN form
to the Komen Ozark Race for the Cure®                                           Register online at komenozark.org                                                                                          G L O B A L M I S S I O N.                                                        L o C A L I M P A C T.

				
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