2017 TCS NEW YORK CITY MARATHON
APPLICATION TO JOIN RESTORE’S TEAM
Thank you for your interest in joining Team Restore!
On Sunday, November 5, 2017, the team will represent Restore in the TCS New York City Marathon, raising
awareness and funds for our work to end sex trafficking in New York and empower survivors.
Participants are provided with guaranteed entry into the 2016 TCS NYC Marathon in exchange for a
commitment to raise a minimum of $3,000 to support Restore.
Name:
Address:
City:
State:
ZIP:
Email:
Phone:
Date of Birth:
Employer:
How did you learn about the Restore NYC Marathon Team?
Why are you interested in participating as part of our team?
What is your personal fundraising goal?
How do you plan to reach your fundraising goal?
Have you ever raised funds for an athletic event before?
Does your employer match charitable contributions?
Have you ever participated in a Marathon before?
Yes ☐
No ☐
If yes, how many?
How many times have you participated in the NYC Marathon?
Have you applied for the 2016 TCS NYC Marathon through the lottery? Yes ☐
Have you already received entry into the Marathon through the lottery for 2016?
No ☐
Yes ☐
No ☐
If yes, please provide entry # here:
Is there anything else you would like to share about your interest in joining the team?
Please e-mail your completed application to [email protected]. You can also mail in the completed
application to 20 West 46th Street, 2B, New York, NY 10036.
Thank you for your support! We will contact you shortly after submission to confirm your placement on the
team. Questions? Email [email protected].
.
© 2017 Restore NYC. P.O. Box 1003, Bowling Green Station, New York, NY 10274 | T. 212.840.8484 | www.restorenyc.org
2017 TCS NEW YORK CITY MARATHON
APPLICATION TO JOIN RESTORE’S TEAM
TERMS AND CONDITIONS - Please Read Carefully & Sign
Fundraising Commitment: A $3,000 minimum fundraising commitment is required to join the Restore
NYC Marathon Team and receive an invitational entry for the 2017 TCS New York City Marathon, which
will take place on Sunday, November 5, 2017.
Valid credit card information must be included with your application to apply for placement on the
Restore NYC Marathon Team. In the event that you do not meet the minimum donation requirement by
Friday, November 3, 2017 at 5:00 PM, Restore NYC reserves the right to charge the balance owed to your
credit card.
We strongly suggest that you raise at least half of the funds by Friday, September 22, 2017. If you have
not raised half of the funds by that date, we may contact you to discuss your fundraising plan.
Cancellation Policy: If for some unforeseen reason you need to withdraw from the Restore NYC Marathon
Team, the following terms apply:


If you withdraw before Thursday, September 7th, 2017 you are responsible for a $75.00 fee
incurred to Restore for the replacement of the marathon spot.
If you withdraw anytime on or after Thursday, September 7th, 2017, Restore NYC reserves the
right to hold you responsible for raising at least half of the $3,000 minimum fundraising
commitment, for any reason, including injury, you are unable to run in the marathon.
You must contact Lauren Culbertson at Restore NYC, in writing, on or before the cancellation dates.
Donations received by Restore will not be refunded, even if you cancel before Thursday, September 7th,
2017.
◦ Registration and Fees: Restore NYC will inform you of the details of registration after we accept and
approve your Marathon application. The TCS NYC Marathon charges a race entry fee that does
not count toward your fundraising minimum ($255 for NYRR members; $295 for non-members).
You will pay this fee when you officially complete your registration with New York Road Runners
(NYRR). NYRR also adds an $11 processing fee to all race registration fees. All race entries are
non-refundable and any entries that are unused after the deadline cannot be transferred to a
future year.
Matching Gift Policy: Many companies match employees’ charitable contributions. We encourage you to
check with your employer to see if your company has a matching gift program, and ask your donors if
their employers match gifts. It is your responsibility to contact the matching company to ensure the
matching gift form will be issued before Friday, November 3, 2017. If Restore NYC does not receive the
matching gift form prior to Friday, November 3, 2017 the match might not count toward your minimum.
© 2017 Restore NYC. P.O. Box 1003, Bowling Green Station, New York, NY 10274 | T. 212.840.8484 | www.restorenyc.org
2017 TCS NEW YORK CITY MARATHON
APPLICATION TO JOIN RESTORE’S TEAM
Liability Waiver and Release Form and Contribution Agreement:
• I know that training for and participating in the TCS New York City Marathon is a potentially hazardous
activity. I understand that I should not enter and participate unless I am medically able to do so and
properly trained. I am voluntarily entering, and I assume all risks associated with training for and
participating in this event, including injuries during training or racing; falls, spills, contact with vehicles or
other participants, the effects of weather, traffic and course conditions, and all other conditions,
foreseen or unforeseen, all such risks being understood and accepted by me.
• Having read and understood this waiver, and in consideration of the acceptance by Restore NYC of me
as a member of the Restore NYC Marathon Team, I, for myself and my legal representatives, successors,
heirs, assigns, executors and administrators, do herby waive and release Restore NYC and its officers,
directors, agents, employees and other representatives from all present and future claims and liabilities
of any kind, known or unknown, foreseen or unforeseen, arising out of or in any way connected with my
training for or participation in this event.
• I hereby grant permission to Restore NYC to use my name and/or photograph, voice or other likeness in
broadcast, telecast, print or any other account of this event for any legitimate purpose.
• I agree to abide by the rules of the TCS New York City Marathon as stated in all official race information.
• I agree to collect a minimum of $3,000 for Restore NYC by Friday, November 3, 2017. If I have not
reached the minimum in sponsorship by that date, I may be personally responsible for the balance owed.
Any amount charged to my credit card will be considered a charitable donation.
• I understand that if for some unforeseen reason I need to withdraw from the Restore NYC Marathon
Team, I am obligated to raise at least half of the required $3,000. I understand that donations will not be
refundable if I do not participate in the Marathon.
• I agree that if the race cannot be held for any unforeseen circumstance, any funds raised by me will not
be refunded.
CREDIT CARD INFORMATION:
Cardholder’s name:
Credit card number:
Billing address:
Credit card type: AmEx Visa MasterCard Other CVV:
Expiration date:
By signing below, you agree to all terms and conditions set forth herein, and authorize Restore NYC to
charge your card in the event that you do not fulfill your fundraising commitment.
____________________________
Applicant’s Signature
_________________________
Date
© 2017 Restore NYC. P.O. Box 1003, Bowling Green Station, New York, NY 10274 | T. 212.840.8484 | www.restorenyc.org