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Registration Info
Download
Printable Registration Form
Register Online
| Pre-register by Sept. 27: $20 On-site registration (Oct. 9): $25 |
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| Name___________________________________________________________ |
| Address__________________________________________________________ |
| City________________________________ State__________ Zip___________ |
| Phone____________________________ E-mail__________________________ |
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Fee enclosed: $________ Make check payable to BTFC If you cannot attend the event and/or would like to make an additional donation, please indicate amount enclosed $__________ |
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| I know that a walk could cause injury. I should not walk unless I am medically able. By my signature I certify that I am medically able to walk and in adequate health. I assume all risks associated with this event, including but not limited to falls, contact with other participants, effects of the weather and all other such risks being unknown. I hereby grant full permission to use my name and any photographs, videotapes or other record of this event for any purpose. Having read this waiver and knowing these facts and in consideration of your accepting my entry I, for myself and anyone entitled to act on my behalf, waive and release the RCTC field house and campus, BTFC and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. |
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| Signature _______________________________________
Date_____________ Parent/Guardian (if participant is under 18) |
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Mail registration form with check and/or donation to: BTFC Special Request If you have pictures of a loved one that you know has or is fighting the battle of a brain tumor, we would like you to send the pictures to us for our tribute wall at the walk this year. Please include date of birth, diagnosis date, and date of death if applicable. Please submit pictures via e-mail to: Sue Steinmetz or Deb Sprau. Thank you.
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