Registration Form One entry per form. All incomplete forms will be returned. We Appreciate Our Partners 5th Annual Mail check payable to: RTCL 268 Cedar Grove Drive St. Charles, MO 63304 Applicant Information Name: ______________________________________________________________________ Address: ___________________________________________________________________ RACE City: __________________________________________ State: ____________ Zip Code: ________________ Phone: ________________________________ TO CURE LYMPHOMA Sex: (M) ____ (F) ____ Email: _____________________________________________ 2010 *your email will not be sold and used exclusively for race updates T-shirt size (circle one): S M L XL XXL YS YM YL Check if: Cancer Survivior: _________ TNT Alumni: _________ Race Information Age (on 10/30) : ________ Birth Date: _________ /_________/_________ There is no finish line until there’s a cure! 5K: ____ 10K: ____ Clydesdale (men > 200) : ____ Athena (women >150) : ___ *Clydesdale and Athena divisions not eligible for age group awards Sprite Sprint: ____ 1 Mile Fitness Walk: ____ Virtual Participant: ____ Team: ____ Team Name: _________________________________________________ 8:00 AM This is my ____ year to run Race To Cure Lymphoma. October 30, 2010 How did you learn about RTCL? Other ___________________________ St. Louis Mills _____ Fleet Feet Website _____ Other Running Website _____ Friend/Family ___ __ LLS Team In Training _____ Media _____ Flyer Hazelwood, MO Entry Fees 5K/10K/1 Mi. Sprite Sprint Total Early entry by October 22 $ 25.00 $ 7.00 $ Late entry by October 29 $ 30.00 $ 11.00 $ 5k Run Race Day on October 30 $ 35.00 $ 15.00 $ Virtual Participant $ 35.00 ------- $ Balloon Release ($1/each) $ Tax deductible donation (IRS tax ID #26-0357509) 1.00 ------- $ $ St Louis Mills Total Amount Enclosed Waiver & Signature $ 10k Run I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I also know that, although police protection will be provided, there will be traffic on the course route. I assume the risk of running in traffic. I also assume any and all other risks associated with running this event, including but not limited to falls and contact with other participants, the 1-Mi. Fitness Walk effects of weather including high heat and/or humidity and the condition of the roads, all such risks being “Success rests in having known and appreciated by me. I agree to abide by all decisions of the race officials relative to my ability to safety complete this race. I agree not to wear headsets, roller blades or skates during the race. I agree not the courage and endurance, to bring baby strollers/joggers, dogs or scooters onto the race course. and above all, the will to become In consideration of my participation, I hold harmless race sponsors, Race To Cure Lymphoma, St. Louis Mills, city of Hazelwood, and all others associated with this difficult event from all liability from injury to the person you are” property or person suffered during this event. This is binding upon my heirs, executors, and administrators. -Dr. George Sheehan I also understand my name and/or photograph may be used in the future promotion of this event. ____________________ _____________________ Signature of Participant / Date Signature of Parent/Gardian Date 636.627.7261 email@example.com No strollers or dogs allowed on course. www.racetocurelymphoma.org Friend Us! Come Join Us This Rocktober! Details Medals For Heroes Time / Date / Location RTCL is excited to unveil a new program to recognize 8:00 A.M. / Saturday, October 30, 2010 Welcome to the greatest 5K/10K on the planet … no, participants and cancer patients. You train hard and to St. Louis Mills, 5555 St. Louis Mills Blvd., Hazelwood, MO seriously, it is! Be sure to join us as the Rocktober tradition celebrate, a limited edition medal will be awarded to all continues. finishers. How to Register Pewter Edition – Top Fifty Finishers Club Guess what!?! Race To Cure Lymphoma is celebrating By mail or online at www.active.com. Photocopy of registration Antique Edition – Remaining Finishers our fifth anniversary! We’re gonna commemorate this is acceptable. Submit one entry per person and include signed awesome milestone and give you a funky fresh T-shirt. and dated check. This program also serves to provide inspiration to cancer You will be stylin and profiling for sure! Results patients. Race To Cure Lymphoma would not be possible Posted shortly after each race and on www.fleetfeetstl.com. without you, the participant, but many cancer patients are We’re excited to have Tom O’Neal from Fox suffering through debilitating treatments and need encourage- 2 News as our emcee. You’ll want to bring Packet Pick-Up ment. The RTCL executive committee will distribute any your family … your friends … and your donated or remaining medals to these heroes through Friends neighbors!!! Come Get YOUR Goodies! of Kids with Cancer. If you know someone who would be We’re all about options … convenient options at that! touched by our program, please contact the race director. Otherwise, a generous donation of your event medal or a Thursday, October 28 – 5:00 to 8:00 P.M. outside Nike Outlet financial contribution will make Medals For Heroes even more in St. Louis Mills successful. Of Course… It’s A Sweet Course! Friday, October 29 – 5:00 to 8:00 P.M. outside Nike Outlet in St. Louis Mills It’s FLAT as a pancake, FAST as a speeding bullet, and Race Day: Saturday, October 30 – 6:00 to 7:40 A.M. at race site exceptionally SCENIC! The route is a 5K loop that surrounds Grab Some Friends And the St. Louis Mills. It’s perfect for both the speedster and Awards stroller. Enter A Team! Worth Getting Out Of Bed For! Do you have a friend or Two water stations will be stocked with POWERADE and water for your refreshment. Our enthusiastic volunteers will Overall – top female & male receive a limited edition Hermes family member who has scream encouragement as you flash, jog, or stroll by. plaque. Much like the Indianapolis 500, they will celebrate in suffered from cancer? Why the winner’s circle with an ice-cold glass of chocolate milk. not enter a team and The event is professionally timed by Fleet Feet Sports and participate in honor or both courses are certified by USAT&F. Age Group – top three women & men in five year brackets memory of that person? receive a limited edition Hermes medal: Race To Cure Lymphoma is more than a competitive Athena – top three women weighing 150 lbs. and over receive You Want Schwag, Right? a limited edition Hermes medal. race and just as much about the cause. If you want to go the “extra mile” and help the Leukemia and Lymphoma Society It’s all about the schwag and you can expect lots of raise funds to fight this disease, contact Cindy at (314) surprises complements of Nike and other race partners. Clydesdale – top three men weighing 200 lbs. and over 878-0780 for more information. Many teams are formed to The first 500 registrations score a unique Nike receive a limited edition Hermes medal. honor others … so what are you waiting for? Get your friends drawstring bag and the next 500 receive a 20% Nike and family to be part of something special! discount coupon. Masters – top three women & men 40+ receive a limited edition Hermes medal. Start your post race recovery with food and POWERADE refreshment. Enjoy an Orange Fly, Fly Away Julius at the finish line and get the royal treatment with a free massage. Balloon Release POWERADE PLAY Sprite Sprint It’s a Race To Cure Lymphoma tradition! Let’s celebrate the Ready? Steady? Spaghetti? Go!!! The Sprite lives of our survivors and remember those who lost their battle Sprint is a 90-yard D-A-S-H for against cancer with an emotional balloon release. Reserve We put the Rock your balloon(s) with a $1 donation. You are encouraged to the kiddos sponsored by POWERADE PLAY. in Rocktober! personalize this awesome tradition by writing the name of your The good folks from POWERADE loved one or friend on your balloon. will be passing out their new kids’ Our favorite cancer-fighting band, Second Wind, will again be rockin’ the Super FUN Costume Contest sports drink and lots of other goodies too. Bring the kids and course for your entertainment. Their music Wear a spooktacular costume and join us for a ghoulishly good lets all have some fun! If you is so good it will make you want to run time. Our judges could pick YOU for one of five, yep, FIVE wanna feel even better, all proceeds another lap. awesome prizes from Nike. from Sprite Sprint will benefit our friends at Camp Rainbow.
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