2017 Team JAF Falmouth Road Race Application

  • Applicant Information

  • Fundraising Experience

  • Please Tell Us About Yourself

  • Running Experience

  • Terms and Conditions:

    You will receive your Falmouth Road Race registration after your application is accepted on Team JAF. All Falmouth Road Race registrations will go directly through JAF. Once accepted, and you will receive our online link to register through us. JAF will pay your registration fee into the race.

    Release Form and Contribution Agreement:

    In consideration of my accepting this entry, I hereby for myself, my heirs, executors and administrator, waive and release any and all rights for claims and damages I may have against JAF and its employees, volunteers, consultants, and product sponsors for any and all injuries suffered or sustained by me in said event, in the training and planning sessions for said event or travel to and from any of the preceding. I further attest and certify that I am physically fit and have sufficiently trained for competition in this event and a licensed medical doctor has verified my physical condition.

    I also grant permission for use of my name and/or photograph or voice in broadcast, telecast, print or any other account of this event and agree to waive any compensation for such use.

    I agree to collect a minimum of $1,250.00 for JAF ($500 for own entry) – due August 14, 2017. If I have not reached the amount in donations by that date, I will be personally responsible for any balance due. JAF reserves the right to charge that balance due to my credit card the date after the commitment is due. I declare that I have exercised my own judgment in signing this agreement and I further declare that the decision to sign this agreement is my own.

    In the situation of a runner who defaults on this agreement and their credit card is not valid for any reason, JAF reserves the right to pursue collection of the debt and the runner will be responsible for any and all legal fees incurred by JAF with this collection process.

    In the event of an illness, injury or medical emergency arising during the event or in the training and planning sessions for said event, I hereby authorize and give my consent to JAF to secure from an accredited hospital, clinic and/or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medication treatment and hospitalization. The following person should be contacted in the event of any emergency:

  • Please sign the below relative to the terms and conditions set forth in the above-mentioned contract. No runner will be considered without providing the required documentation. I have received the Joe Andruzzi Foundation Falmouth Road Race application and understand all the terms and conditions of my participation in the 2017 program. I am confirming the information listed in the enclosed application. I have also noted the due date for material submission and fundraising goals.

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