Color out Cancer fun Run
5K Color Fun Run/Walk
Saturday, October 11, 2014, 9:00 am
*This is not a timed event*
Early Registration:
Complete the registration form below
Make all checks payable to
Conway Cancer Foundation
Mail OR drop off
Conway Hematology Oncology
2605 College Ave Conway, AR 71730
All proceeds to
Conway Cancer Foundation
to be used for scholarships for
eligible children of cancer patients,
groceries, gas, assistance with
medicine, etc
T-shirt Pick Up/ Late Registration:
Friday, October 10, at The Sporty Runner in Conway
Late registration will be after September 26, 2014 (you may still register we just cannot
guarantee a t-shirt)
Registration/ T-shirt Pick Up Party
Need to set this up
Entry Fee:
$5.00 tshirt only – 0-12 years
$25.00 – 13 & up
**Color powder is all natural and safe**
Cut and send form below
Questions? 501-327-2995
*** T-Shirts guaranteed to the first 100 registrants ***
Cut and send form below
T-Shirt Size: YOUTH: Y XS____ YS____ YM____ YL____ ADULT: S____ M____ L____XL____ XXL ___
Name (Print):_____________________________________
Age (on event day):_____
Sex: M____F____
Address: __________________________ City/Town: _________________ State:____ Zip:__________
Phone: ___________________ E-mail (only for race updates):_________________________________
Total Fee Paid: _________________________ Additional Donation to CCF: ___________________________
WAIVER AND ASSUMPTION OF RISK:
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 assume all risks
associated with running including but not limited to falls, contact with other participants, the effects of the road and traffic; all such risks being known by me. Having
read this waiver and knowing these facts, I, for myself, and my heirs and assigns, and anyone else entitled to act on my behalf, do waive and release the 5K Race
Committee, the Town of Conway,, and all sponsors, their directors, officers, and volunteers from all claims of liabilities of any kind or nature whatsoever arising out of
my voluntary participation in this race, even though that liability may arise from negligence or carelessness on the part of the persons named in the waiver.
Signature (Parent, if under 18):______________________________________Date:_________________
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Color out Cancer fun Run