Race Registration - Community Breast Care Project

Adult: $20.00
Youth: $15.00
Name: ______________________________Age_____
Name: ______________________________Age_____
Name: ______________________________Age_____
Name: ______________________________Age_____
Address: ____________________________________
Community Breast Care Project
2854 S. Ten Mile Drive
Jefferson City, MO 65109
REGISTRATION REQUIRED
City:____________________State____ Zip: ______
Email: ______________________________________
____________________________________________
Shirt Sizes Needed: (circle one for each reg.)
Adult S
M
L
XL
XXL
Youth S
M
L
XL
Event: Circle One
Women’s Run
Men’s 5K Fun Run
Women’s Walk
Each registrant will receive a t-shirt the day of the race provided
you have pre-registered. Make checks payable to CBCP and
mail to:
CBCP, 2854 S. Ten Mile Drive, Jefferson City, MO 65109
More information and online registration is
available at www.communitybreastcareproject.org
5K
Walk/Run
Saturday, May 9, 2015
8:00 am Registration
9:00 am Start
Race Waiver and Release:
I understand that my consent to these provisions is given in consideration of the
acceptance of this registration and for being permitted to participate in this
event. I am a voluntary participant in this event, and in good physical condition. I know that this event is a potentially hazardous activity and I hereby
assume full and complete responsibility for any injury or accident which may
occur during my participation in this event or while on the premises of this
event, and I hereby release and hold harmless and covenant not to file suit
against The Community Breast Care Project, The Jefferson City Roadrunners,
and any affiliated individuals, any race sponsor and their agents and employees,
and all other persons or entities associated with this event from any loss, liability or claims I may have arising out of my participation in this event, including
personal injury or damage suffered by me or others, whether same be caused by
falls, contacts with participants, conditions of the course, negligence of the
sponsors or otherwise. If I do not follow the rules of the event, I understand
that I may be removed from participation.
Signature:____________________________________
Date: _______________________________________
Start/Finish at
North Jefferson City Pavilion
927 Fourth St, Jeff City, MO
(Cedar City Pavilion)
573-634-HOPE
Register online at
communitybreastcareproject.org
Door Prizes::
There will be lots of prizes, including prizes
from area businesses, You don’t want to
miss out on this event.
Safe and Enjoyable
Course::
Start/Finish at North JC Pavilion. The
course will be much flatter than previous
years.
Our Mission
To provide educational, financial and emotional
support to the Central Missouri community
regarding awareness of breast health and
breast cancer treatment.
Officers and Board Members
Our Officers and Board Members come from all
sectors of our community - health care,
banking, business and education. We share a
common goal of raising awareness and helping
women in Central Missouri.
Awards:
Awards will be given to the overall walker/
runner as well as other top finishers.
Age Categories:
14 and Under
15-19
20-29
30-39
40-49
50-59
60-69
70 and over
CBCP Board Members
Laurelanne Bellezzo
Nancy Gratz
Linda Harvey
Mariam Kuensting
Buffy Phillips-Kiss
Lorie Smith
Vicky Stafford
Denise Tritz
The Walk/Run Starts Here!
The purpose of this event is to
help fund the Community
Breast Care Project
Financial Aid
The Community Breast Care Project will provide
financial aid to anyone who meets the following
requirements:
• You must reside in Cole, Callaway, Miller,
Moniteau, Morgan or Osage county.
• You must have a new diagnosis of breast
cancer within the last 12 months.
• No more than $500 will be given to any one
person
To date financial aid checks have helped 106 women
in Central Missouri totaling $53,000 in financial aid.
Resource Notebooks
The Community Breast Care Project provides
resource notebooks to area doctors to be given to a
patient with a new breast cancer diagnosis. These
books are used to keep all of their important papers
like their medication journal and their appointment
times and doctor contact information. The notebooks
also contain encouraging letters from survivors.
The Ra Ra Sisterhood
The CBCP’s support group is called the Ra Ra Sisterhood with over 55 members who meet once a month
to enjoy camaraderie and listen to speakers pertinent
to breast cancer survivors. We also exchange
encouraging notes and cards when someone is facing
treatments or a surgery.
Refreshments:
Will be provided during the race. Refreshments and
fruit will be available after the race.
Pre-Registration
Required:
Make Checks Payable to:
Please register by Friday, May 2, 2014, t-shirts
guaranteed to all with advanced registration. If you
are a walk in shirts will be available on a first come
first serve basis and will only be available the day of
the race if we have shirts left over after serving all of
the pre-registered walk/runners.
CBCP
Mail to: 2854 S. Ten Mile Drive
Jefferson City, MO 65109
Or Fax to: 888-634-5202
Remember to invite all of your friends to join you.
North Jefferson City Pavilion
927 Fourth Street
Jefferson City, MO
(Cedar City)