Kornerstone, Inc.
5K Run/Walk Registration
SEPTEMBER 9 2017      
AQUATIC PARK, CASSVILLE
Kornerstone
Kares for
KIDS
5K
Benefiting Kornerstone’s Teen Parent  Educational Program
Scenic Run/Walk through the country side
Start and finish:  Aquatic Park, Cassville
Registration and cost: Registration before August 30th  is $25.00 and includes a t-shirt.  
Registration after August 30 is $25.00/no shirt.   Deadline 8:30am on September 9th
.
Awards:  Top 3 male and female finisher in each category will receive first, second and
third place medals.
Overall winner: Top male and female winner will receive first place trophy.
Categories are according to age:  13 –19, 20-29, 30-39, 40-49, 50-59, 60 and up

Gold and Silver medal for first and second fur friend to cross the line with owner.
Ozark Racing Systems will provide official timing of the
event
ADDITIONAL T-SHIRTS AVAILABLE FOR $15.00
In consideration of acceptance of this entry and my participation in this event, I,
the undersigned, accept all risk to my health and assume full responsibility for any
injury or accident which may occur during this event or while I am on the premises
of this event.  I release and hold harmless the sponsors and promoters of this
event and all other persons and entities associated with this event (the “Event
Parties”) from all claims and causes of action for loss of or damage to my property
and for any and all illness or injury to my person, whether it be caused by the
negligence of the sponsors, promoters or otherwise
.


Name_______________________________ Age ___________Gender   M      F
_
Address ____________________________
_
Email Address________________________

Contact Number_______________________

T-shirt size  S  M  L  XL

Signed________________________________

Guardian If under 18______________________

Fur Childs'sName________________________breed   _________________________
Pets must be on leash and owner holds all responsibility for actions and
care of the animal.
Mail with fee to
Kornerstone  P.O Box 396
5K Race
Shell Knob, MO 65747