Big Brothers Big Sisters of Massachusetts Bay 2016 Marathon Team Application (Non-Qualified) - Big Brothers Big Sisters of Eastern Massachusetts

Name*

First

Last

Date of Birth*

Gender*

Male
Female

Phone*

Address*

City

State / Province / Region

ZIP / Postal Code

Country

Email*

Employer*

Title*

Work Address*

Street Address

Address Line 2

City

State

ZIP Code

Work Phone*

Runner Singlet Size*

Emergency Contact Info*

Have you ever participated in an endurance sporting event charity event before? (includes run, walk bike)*

If yes, which event and charity?*

How much money did you raise and what was your fundraising strategy?*

Why do you want to run for BBBSMB?*

What is your fundraising goal?*

As we anticipate a high number of applications for the 2015 Big Brothers Big Sisters of Massachusetts Bay Marathon Team, we are looking for runners who are enthusiastic and motivated to successfully train and surpass the fundraising minimum of $7,500.

How do you plan to meet your goal?

include levels of how you plan to get to $1,000, $5,000, etc.

Does your company offer matching gifts?*

Have you ever run a marathon before?*

If yes, please tell us how many and which ones:*

What other races have you participated in?*

How would you describe your running level?*

Are there any other ways you'd like to get involved with BBBSMB?*

What is your connection to BBBSMB?*

I commit to fundraise a minimum of $7,500 for my opportunity to run in the 119th Boston Marathon.*

Yes
No

This includes being solely responsible for raising or personally giving the entire fundraising minimum, even if for any reason, including injury, I am unable to run in the 2016 Boston Marathon.

I understand that my initial $25 application fee is non-refundable*

Yes
No

I agree that BBBSMB reserves the right to charge the outstanding balance towards my $7,500 pledge to the card number provided*

Yes
No

If chosen, I agree to pay a $350 race application fee to the Boston Athletic Association. I understand that this does not count toward my fundraising minimum for Team BBBSMB. I will not contact the BAA directly to secure my number.*

Yes
No

I understand I am solely responsible for raising the entire fundraising minimum, even if for any reason, including injury, I am unable to run.*

Yes
No

I will not hold Big Brothers Big Sisters of Massachusetts Bay responsible for injury or death related to training for, or participating in the Boston Marathon as part of Team BBBSMB.*

Yes
No