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Trek Across Kansas
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*
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Trek Across Kansas
Get your teams together to "Trek Across Kansas" for a distance of 425 miles. From May 22 to July 31, track the number of miles walked or ran (no bicycle miles will count.) Every team that reaches their goal will receive t-shirts. Teams will consist of 1 to 5 members. Team captains will be responsible for reporting team miles weekly. Kids can form their own team or participate with the family. Create a team with your co-workers. Gather your neighbors to form a team. Motivate each other and stay active this summer!
Team Name
*
Team Captain Name
*
First
Last
Team Captain Phone Number
*
Team Captain Email
*
Number of Teammates
One
Two
Three
Four
Five
Team Captain Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Participation Waiver
*
I agree to the participation waiver.
We, or I, as parent and/or legal guardians of the participant named above, herby give consent for my child to participate in this program and all other activities incidental thereto, including practice, actual participation, being a spectator thereto, and any incidental travel connected with the activity. I further agree to assume full responsibility in case of any accidental injury incurred while participating in this activity. By enrolling, I waive and release all rights and claims arising from this activity against the Clearwater Recreation Commission, the City of Clearwater, USD #264, its representatives, successors and coaches from injury, illness and accident resulting in participation in this program.
Team Captain Signature
*
Phone
This field is for validation purposes and should be left unchanged.
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