Kyle’s Summer Classic 5K Run/Walk Registration Form 2023 Kyle's Summer Classic Signature Reset signature Signature locked. Reset to sign again Name* First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please list the best contact number for you.Are you a member of the Jefferson City Roadrunners Club?* Yes No Shirt Size* Youth Unisex Small Unisex Medium Unisex Large Unisex X-Large Unisex XX-Large Please select the best size shirt for you - these are unisex shirts. Shirts guaranteed to the first 100 EntrantsAge*Please submit your age on July 15, 2023.Gender* Female Male Race* 5K Run - Some walking allowed 5K Walk - NO JOGGING allowed Note: There is a $2 processing fee per race entry. Race Entry Fee for entry #1* Price: Signature* Reset signature Signature locked. Reset to sign again NOTE: IF YOU ARE UNDER 18 years of age this form must be signed by your legal guardian. RELEASE: In the consideration of the acceptance of my entry, I, for myself, my administrators, executors and assignees, do hereby release, and discharge the Jefferson City Roadrunners and all other sponsors for all claims of damages, demands and actions, whatsoever arising or growing out of my participation in said athletic event. I attest and verify that I have full knowledge of the risk involved in this event and I am physically fit and trained for this eventWould you like to register more than one person for the race?* No Yes Second EntryName* First Last Are you a member of the Jefferson City Roadrunners Club?* Yes No Is the contact information the same for both entries?* Yes No Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please list the best contact number for you.Shirt Size* Youth Unisex Small Unisex Medium Unisex Large Unisex X-Large Unisex XX-Large Please select the best size shirt for you - these are unisex shirts. Shirts guaranteed to the first 100 EntrantsAge*Please submit your age on July 15, 2023.Gender* Female Male Race* 5K Run - Some walking allowed 5K Walk - NO JOGGING allowed Note: There is a $2 processing fee per race entry. Race Entry Fee for entry #2* Price: Signature* Reset signature Signature locked. Reset to sign again NOTE: IF YOU ARE UNDER 18 years of age this form must be signed by your legal guardian. RELEASE: In the consideration of the acceptance of my entry, I, for myself, my administrators, executors and assignees, do hereby release, and discharge the Jefferson City Roadrunners and all other sponsors for all claims of damages, demands and actions, whatsoever arising or growing out of my participation in said athletic event. I attest and verify that I have full knowledge of the risk involved in this event and I am physically fit and trained for this eventWould you like to register more than two people for the race?* No Yes Third EntryName* First Last Are you a member of the Jefferson City Roadrunners Club?* Yes No Is the contact information the same for all three entries?* Yes No Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please list the best contact number for you.Shirt Size* Youth Unisex Small Unisex Medium Unisex Large Unisex X-Large Unisex XX-Large Please select the best size shirt for you - these are unisex shirts. Shirts guaranteed to the first 100 EntrantsAge*Please submit your age on July 15, 2023.Gender* Female Male Race* 5K Run - Some walking allowed 5K Walk - NO JOGGING allowed Note: There is a $2 processing fee per race entry. Race Entry Fee for entry #3* Price: Signature* Reset signature Signature locked. Reset to sign again NOTE: IF YOU ARE UNDER 18 years of age this form must be signed by your legal guardian. RELEASE: In the consideration of the acceptance of my entry, I, for myself, my administrators, executors and assignees, do hereby release, and discharge the Jefferson City Roadrunners and all other sponsors for all claims of damages, demands and actions, whatsoever arising or growing out of my participation in said athletic event. I attest and verify that I have full knowledge of the risk involved in this event and I am physically fit and trained for this eventWould you like to register more than three people for the race?* No Yes Fourth EntryName* First Last Are you a member of the Jefferson City Roadrunners Club?* Yes No Is the contact information the same for all four entries?* Yes No Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please list the best contact number for you.Shirt Size* Youth Unisex Small Unisex Medium Unisex Large Unisex X-Large Unisex XX-Large Please select the best size shirt for you - these are unisex shirts. Shirts guaranteed to the first 100 EntrantsAge*Please submit your age on July 15, 2023.Gender* Female Male Race* 5K Run - Some walking allowed 5K Walk - NO JOGGING allowed Note: There is a $2 processing fee per race entry. Race Entry Fee for entry #4* Price: Signature* Reset signature Signature locked. Reset to sign again NOTE: IF YOU ARE UNDER 18 years of age this form must be signed by your legal guardian. RELEASE: In the consideration of the acceptance of my entry, I, for myself, my administrators, executors and assignees, do hereby release, and discharge the Jefferson City Roadrunners and all other sponsors for all claims of damages, demands and actions, whatsoever arising or growing out of my participation in said athletic event. I attest and verify that I have full knowledge of the risk involved in this event and I am physically fit and trained for this eventWould you like to register more than four people for the race?* No Yes Fifth EntryName* First Last Are you a member of the Jefferson City Roadrunners Club?* Yes No Is the contact information the same for all five entries?* Yes No Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please list the best contact number for you.Shirt Size* Youth Unisex Small Unisex Medium Unisex Large Unisex X-Large Unisex XX-Large Please select the best size shirt for you - these are unisex shirts. Shirts guaranteed to the first 100 EntrantsAge*Please submit your age on July 15, 2023.Gender* Female Male Race* 5K Run - Some walking allowed 5K Walk - NO JOGGING allowed Note: There is a $2 processing fee per race entry. Race Entry Fee for entry #5* Price: Signature* Reset signature Signature locked. Reset to sign again NOTE: IF YOU ARE UNDER 18 years of age this form must be signed by your legal guardian. RELEASE: In the consideration of the acceptance of my entry, I, for myself, my administrators, executors and assignees, do hereby release, and discharge the Jefferson City Roadrunners and all other sponsors for all claims of damages, demands and actions, whatsoever arising or growing out of my participation in said athletic event. I attest and verify that I have full knowledge of the risk involved in this event and I am physically fit and trained for this eventPaymentWe use PayPal for secure online payments. Please be patient as you will be redirected to their site. NOTE: You do not have to be a PayPal member to pay. Simply select "Pay With A Debit or Credit Card" at the bottom of the form. Thank you!Total $0.00