Stomp Out Hunger Event Registration Form

2nd Annual Stomp Out Hunger 5K Run & 1 Mile Walk

Stomp Out Hunger Registration Information

Please provide the following information to complete your registration

Name

First Name

Last Name

Address

Street 1

Street 2

City

State

Zip

E-mail

Phone

List (Dropdown)

Choose the Age Group *

Please enter your age group or select the 1 Mile Walk (No Age Required) and a Fun Event!

T Shirt Size
Required*

Select One*

Tell us what size T-Shirt you will need.

Additional Donation to Hale Kau Kau

	Thank you for your choice to donate an additional amount to the Hale Kau Kau Foundation
Donation Amount	Please list the numerical value of your pledge to HKK	Your pledge is greatly appreciated. Your checks can be accepted at the Hale Kau Kau Office located at 25 W. Lipoa Street, Kihei, Maui 96753

Event Waiver

	I know that running a road race is potentially a hazardous activity. I attest that I am adequately trained and conditioned to run this event. I agree to abide by the decision of the race director to participate. I assume all risks associated with running this 5k/1mile walk including but not limted to tripping and falling, hot and humid conditions, traffic and all other conditions of the road. Having read the waiver and knowing these risks and in consideration of your accepting my entry, I for myself, and anyone entitled to act on my behalf waive and release HKK, the County of Maui, and the State of Hawai'i from all claims of liability of any kind arising out of my participation in this event.
Signature	Providing your name in this field acts as your signature	Please type your name in the field to acknowledge your agreement to Event Waiver.

Fees and Registration

	Please note the following fees and registration information
Thank you for your interest, but the deadline to register for this event has passed and we are no longer accepting registrations. Thank you for your interest, but the deadline to register for this event has passed and we are no longer accepting registrations.
	Annual Stomp Out Hunger 5k-1mile Run/Walk 25 Lipooa Street Time: October 20, 2018 8:00 Am - October 20, 2017, 9:30 Am Earlybird Registration Cost: $20.00 Deadline: 10/16/18 Registration Cost: $30.00 Deadline: 10/20/18

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