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I, the undersigned, for and in consideration of the benefit derived by participating in Girls on the Run 5k presented by YWCA of Northeast Kansas do hereby release and forever discharge the YWCA of Northeast Kansas, its agents, volunteers and staff from and against any all liability and responsibility for any injury, illness or sickness which may result from my participation in the in Girls on the Run 5k event and do hereby further agree to indemnify and hold harmless the YWCA of Northeast Kansas, volunteers and staff from any and all liability in such regard. In addition, I grant the YWCA of Northeast Kansas full rights to copyright, exhibit, and publish in any medium including, but not limited to, editorial, illustration, promotion, advertising, internet, or trade all photographs taken by the YWCA of Northeast Kansas or its agents as I participate in the in Girls on the Run 5k events. 

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We are committed to making Girls on the Run available to every girl in Northeast Kansas who wants to participate. We do this through sponsorship, in-kind donations, fundraisers, and individual giving.

$10 - provides healthy snacks to one girl for one season 
$50 - provides a pair of running shoes and healthy snacks to a girl for one season 
$100 - provides healthy snacks to an entire team of girls for one season 
$150 - provides the Girls on the Run program to one girl for one season 
$300 - provides Girls on the Run program to one girl for one school year 
$2,500 - provides the Girls on the Run program to an entire team of girls for one season

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Pick any that apply

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Please include GOTR Girls Name and Site
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