Catch the Spirit 5KWalk/Run
benefitting the Harrisonville Public School Foundation
& the Christina Collins Memorial Scholarship

Saturday, September 15, 2012
8 a.m., Harrisonville High School Student Parking Lot

Pre-Registration (by Aug. 31) - $20
Family Plan (see explanation below) - $10
Registration after Aug 31 through race day- $25 (NO T-SHIRT)
Dream Partner (by Aug. 31) - $25
**Only Pre-Registrants & Dream Partners receive t-shirts
**Race Day Registrants may purchase a t-shirt at the event - $10

**NEW**—Family Plan
If you have an elementary-age child or children who would like to partipate with you, you can register them under the new Family Plan for only $10 each.  If you register by Aug. 31, they can also receive a shirt.  Late registration for elementary students is still $10, but they will not receive a shirt.  **NOTE:  The Family Plan is only available if at least one parent registers at regular cost with the child or children.

Payments can be mailed to HPSF, 503 S. Lexington, Harrisonville, MO 64701



Full Name
 
First Name
M.
Last Name
Gender
 
Age
 

NOTE: If registrant is under 18, a waiver form must be printed, signed by a parent or guardian,and turned in prior to participation. The waiver for is attached above. It can be mailed (503 S. Lexington), turned in on race day, or scanned and attached below.
Address
 
Address 1
Address 2
City
State
Zip Code
Email Address
 
Shirt Size (Adult)
 
Registration/Donation Type
 
HHS Team/Organization Plan - Team Name
 
Payment Information
 
Sponsor Information
Business/Organization Name
 
Contact Person
 
Business/Organization Address
 
Address 1
Address 2
City
State
Zip Code
Contact Email Address
 
**If True Wildcat or Royal Blue Sponsor - Logo file for use on t-shirt may be attached below
Waiver Statement for Participants
 
 
I assume full responsibility for any injury or accident, which may occur during participation in the event or while on event premises. I release and hold harmless sponsor, promoters, and all persons, and entities associated with the event. I will not enter unless medically fit and properly trained. I know there may be traffic on the course. I assume the risks associated with the event, including but not limited to fall, contact with other participants, effects of weather including heat and/or humidity, and conditions of the road. If used, I assume all responsibility as associated with the operation of a baby jogger. I grant my permission to use photographs, videotape, or any other record of this event. I have read the foregoing and certify my agreement by check the box below.
Waiver Agreement
 


NOTE: If registrant is under 18, a waiver form must be printed, signed by a parent or guardian,and turned in prior to participation. The waiver for is attached above. It can be mailed (503 S. Lexington), turned in on race day, or scanned and attached below.