Win the 2008 Run in the Dark “Storehouse Cup”
9th Annual Run in the Dark Saturday, September 20, 2008 Keller Town Hall • 5:00 PM
Community Storehouse is a local nonprofit relief organization that is “dedicated to the well being and education of the children in our community.” Help us by registering for the 9th Annual Run in the Dark on September 20, 2008 at Keller Town Hall. School Competition for the “Storehouse Cup” This will be our first year to award the “Storehouse Cup” to the school that has the largest school team participation. A school team consists of any child or adult that registers under that school name. The school with the most registrations for their team will be awarded the “Storehouse Cup” on stage and will hold the cup for the year at their school. Entries must be received by September 19 to be counted toward the school competition. Schedule 5:00–6:30 pm Race day registration & packet pickup 5:00–9:00 pm Live entertainment 7:00 pm 1-mile fun run; 7:30 pm 5K run/walk 9:15 pm Awards ceremony & Storehouse Cup presentation Register ONLINE: Aug. 1-Sept. 16 at www.communitystorehouse.org Register IN PERSON: Aug.1-Sept.16, M–F 8:30 am–2:00 pm • Community Storehouse, 4574 Keller-Hicks, Keller September 18-19 from 10:00 am–7:00 pm • Tom Thumb, 1000 Keller Parkway, Keller, 76248 • Kroger, 976 Keller Parkway, Keller, TX 76248 September 20, 5:00 pm–6:30 pm at Keller Town Hall Register BY MAIL: Send completed registration form and payment to: Community Storehouse, P.O. Box 13, Keller, TX 76244. Checks payable to: Community Storehouse More information at www.communitystorehouse.org or (817) 431-3340
Storehouse Cup Participant Entry Form - all ages
Name: __________________________________________________ Age (as of 9/20/08): ___________ Date of birth: ____________ Sex (circle one): Female Male School Name: _______________________________________________________________
Address:________________________________________________ City: ___________________ State: _____ Zip: _____________ Email: ______________________________________________________ Daytime Phone: __________________________________ T-shirt size: ___Youth SM ___Youth MED ___Youth LG ___Adult SM ___Adult MED ___Adult LG ___Adult XLG ___Adult 2XLG Event (entry fee includes the 1-mile and 5K): 5K 1-Mile Fun Run
School Competition Registration (includes1-mile & 5K) - all ages - deadline for storehouse cup competition 9/19/08: Register August 1-September 11 = $12 per person Register September 12-19 = $15 per person I Will Pick Up My Shirt and Race Bib: _____Tom Thumb (Sept. 18–19) _____Kroger (Sept. 18–19) _____Race Day (Sept. 20) Race registration enclosed $___________ + Additional Tax-Deductible Donation $___________ = Total Enclosed $___________
Waiver Statement: I acknowledge that running/walking near automobiles and bicycles is extremely dangerous and that running/walking is an extreme test of a person’s physical and mental limits and there exists the possibility for death or serious injury. I certify that I am physically fit, have sufficiently trained for this event and have not been advised otherwise by a qualified medical person. I assume the risks of participation and assume full responsibility for injury, accident, or illness which may occur during the event or while I am on the premises of the event and I hereby release and hold harmless Community Storehouse, the City of Keller, volunteers, sponsors, promoters or the persons or entities associated with this event from any and all injury or damage whether it is caused by negligence of the sponsors, promoters, persons or entities associated with this event or otherwise. Further, I hereby grant full permission to any and all of the foregoing to use photographs, videotapes, motion pictures, recordings or any of record of this event. Race officials reserve the right to refuse registration to anyone for any reason. Race will be held regardless of weather conditions. Registration is final, no refunds. T-shirt quantity is limited. Shirt and size are not guaranteed after September 10, 2008.
Participant or Parent/Guardian (if under 18 yrs.) Signature: _________________________________________________ Date: ________________
www.communitystorehouse.org
Personal Chip
Number Bib