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2008 Gobbler Grind Official Entry Form
Please use ball point pen.  One person per entry form.  Photocopies will be accepted.  Incomplete entry forms will not be accepted.
*Release & Waiver below must be signed to participate*
Personal Information

First Name_____________________ Last Name____________________

Address_________________________ City/ST________________ZIP______

Age______  Gender______ Date of Birth_________________

Phone_______________ E-mail_____________________________________

Participant's Signature___________________________ Date__________
(I will abide by the Release & Waiver below)

Parental Signature (required for minor participation)______________________
Entry Fees & Deadlines
Fee through              10/31/08   11/21/08   11/22/08
Marathon                     $60            $70            $80
Half-marathon              $35            $40            $45      Additional
5K                                $25            $30            $35       Donation  $_______
T-shirt Size (circle)  SM  MD  LG  XL  XXL               Total Enclosed  $_______
Please make payment to: Gobbler Grind, c/o Safety Council
                                         5829 Troost, Kansas City, MO 64110
Release & Waiver
I know that running is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I also know that police protection is provided but there will be traffic on the course. I assume all risks of running in traffic. I also assume any and all other risks associated with running this event including but not limited to falls, contact with other participants, the effects of weather and the condition of the roads and running trails, all such risks appreciated and known by me. Knowing these facts and in consideration of your accepting my entry, I hereby for myself, my heirs, executors, administrators or anyone who may claim on my behalf, covenant not to sue, waive, release and discharge Rusty Collins, The Safety & Health Council of Western MO & KS any and all sponsors, the Cities of Overland Park, KS and Olathe, KS, their agents, employees, assigns or anyone acting on their behalf. This release and waiver extends to all claims of every kind or nature whatsoever, forseen or unforseen, know or unknown, including any injury even death.  I give permission to use any and all photography or video that may be recorded during this event.  Minors must have parental signature to participate.