2017 TCS New York City Marathon
The Carol M. Baldwin Breast Cancer Research Fund, Inc. is proud to be among the New
York Road Runners’ official charity partners for the 2017 New York City Marathon.
This is our sixth year and the Carol M. Baldwin Breast Cancer Research Fund, will provide
guaranteed marathon entries to runners who pledge to raise funds for Team Baldwin. .
The runners who participate on behalf of Team Baldwin will receive fundraising guidance as
well as extensive pre-race and race day support.
APPLICATION AND FUNDRAISING INFORMATION
A limited number of guaranteed entries are available for this event. To be considered for an
entry, each runner must commit to make a donation or raise funds totaling $3,000 or more to
the Carol M. Baldwin Breast Cancer Research Fund, Inc.
The Baldwin Fund was established in 1996 as a 501(c)3 non-profit organization, and your
tax-deductible donations help fund research for a cure for breast cancer.
Fundraising Commitment
A $3,000 minimum fundraising donation is required to secure your guaranteed entry into the
2017 TCS New York City Marathon.
Your credit card information is required as a guarantee against the pledge. The Carol M.
Baldwin Breast Cancer Research Fund reserves the right to charge the balance to the credit
card we have on file if the $3,000 is not raised by 11:59 pm EST on October 20, 2017.
Fundraising Deadlines and Deferment Policy
Once you accept an entry into the 2017 TCS NYC Marathon from Team Baldwin, a minimum of
$3,000 must be raised and collected. If for any reasons you can’t run you can defer your spot
for the following year but payment is still due.
After October 20, 2017 you are responsible for the $3,000, even if you defer to the
following year. Note: Donations raised and received by the Carol Baldwin Fund, cannot be refunded.
Marathon Application
You may download the NYC Marathon charity application at www.mynyrr.org/login
NYC Marathon Charity Application
Please email application to [email protected]
Online Fundraising
For directions on how to utilize Crowd Rise to raise money online, please visit our website.
Donations made by Check
All checks should be made payable to the Carol Baldwin Breast Cancer Research Fund, Inc.
Please include the runner's name and "NYC marathon" in the memo line.
Mail checks to:
Carol M. Baldwin Fund
Attn: NYC Marathon
14 Technology Dr. Suite 2
Setauket, NY 11733
Support Our Runners
To make a donation in support of our runners, please visit the Team Baldwin page on
CrowdRise.com
Contact Anne Line at [email protected] or 631 444-4302 for support.
2017 TCS New York City Marathon
November 5, 2017
Release Form & Contribution Agreement
In support of Team Baldwin & the Carol M. Baldwin Breast Cancer Research Fund, Inc.
Release Form & Contribution Agreement:
In accepting this entry, I hereby for myself and anyone entitled to act on my behalf, waive and release
any and all rights to claim for damages I may have against the Carol M. Baldwin Breast Cancer Research Fund, Inc. and sponsors for all injuries suffered by me leading up to or during the 2017 TCS
NEW YORK CITY MARATHON. I further attest and certify that I am physically fit at present and will
sufficiently train for competition in this event, and a licensed medical doctor has verified my physical
condition. I agree to collect a minimum of $3,000 for the Carol M. Baldwin Breast Cancer Research
Fund, by October 20, 2017.
The purpose of the Team Baldwin New York City Marathon Group is to raise awareness and muchneeded funds to find a cure for breast cancer by supporting research.
As a marathon participant, I agree to take on this mission and adhere to all fundraising commitments/
cancellation policies as follow:
 A minimum amount of $3,000 must be raised and collected by the Carol M. Baldwin Breast
Cancer Research Fund, Inc. by October 20, 2017.
 A $50 Registration Fee will be charged to my credit card upon acceptance to Team Baldwin. This amount will count toward my fundraising minimum.
 A Dedication Deposit of $1,500 (50% of the total) is due by September 8, 2017. If I have not
raised this amount by the due date, I will be allowed to personally make up the difference by check or
credit card. If I do not raise or pay this amount, my marathon entry is subject to forfeit.
AFTER October 20, 2017, I AM RESPONSIBLE FOR RAISING THE $3,000 MINIMUM, EVEN IF I
DEFER FOR ANY REASON, INCLUDING INJURY.
November 5, 2017
CREDIT CARD INFORMATION
In support of the Carol M. Baldwin Breast Cancer Research Fund, Inc.
___________________________________________DofB_________________SS#___________
NAME (as it appears on your credit card)
CIRCLE ONE:
AMEX
MC
VISA
DISCOVER
_________________________________________________________________________
CREDIT CARD NUMBER, EXPIRATION DATE (mm/yy) SEC. CODE
_________________________________________________________________________
BILLING ADDRESS FOR CREDIT CARD
_________________________________________________________________________
CITY
STATE
ZIP
_________________________________________________________________________
PHONE
EMAIL
__________________________________________________________________________
APPLICANT’S SIGNATURE
DATE