Team Reconciliation Form - Susan G. Komen Colorado Race For The Cure

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Team Reconciliation Form
Susan G. Komen Colorado Race for the Cure®
Denver
Directions and necessary attachments:
1. Complete team reconciliation form prior to coming to team packet pick up
2. Each registration form must have the Team Name printed clearly on it
3. Attach copies of all signed paper race registration forms from team members with form of
payment
Total number of team members (paper registration) being submitted with this form: ______________
Team Captain: _______________________________
E-mail:
________________________________________________________________________
Phone (AM) ______________________________ (PM) _______________________________________
Company/Organization/Team Name
_____________________________________________________________________________
Street Address: _______________________________________________________________________
City ___________________________________ State_______ Zip ___________
T-shirt Breakdown
Directions:
1. Include paper registration forms only. All individuals who registered online had their shirts and bibs mailed.
2. Survivors receive a Survivor T-shirt only.
3. Only Race Day participants receive bibs (excludes Sleep In). Kids for the Cure will receive a bib only, no shirt.
T-SHIRTS
BIBS
Sleep In
T-Shirt Size
Race T-shirt
T-shirt
Survivor
Event
Qty
7:45am Competitive Run
Child Medium
N/A
_____
8:00 am 5k Walk/Run
Adult Small
_____
9:00 am Family Walk
Adult Medium
Sleep In
Adult Large
N/A
Survivor
Adult X-Large
Kids for the Cure
Adult XX-Large
(age 3 & under)
Adult 3X-Large
Total T-Shirts_________________________
Total Bibs_______________
INCLUDE ONLY PAPER REGISTRATIONS IN THESE NUMBERS (payment for on-line has already been received).
Paper Forms Only
Registration Type
Total
Office Use Only:
Qty
Fee
Payment of Monies Due
Total
ADULT
@
$
$35
Checks
$
YOUTH / SENIOR
@
$
Cash
$
11-21/65 & over
$25
Credit Cards (Type_____________)
$
CHILD
@
$
10 & under
$15
Grand Total**
$
KIDS FOR THE CURE
FREE
$
3 & under (NO SHIRT)
DONATIONS
N/A
N/A
$
**Totals Must Match
TOTAL DUE**
$
Captain: Please keep a copy for your records.

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