5k Run 5k Run by wpr1947


									                                      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: ___________________________________________________________________

City: __________________________________________ State: ____________

Zip Code: ________________ Phone: ________________________________
                                                                                                                                               TO CURE
Sex: (M) ____ (F) ____ Email: _____________________________________________

                       *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
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
                           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
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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