"*" indicates required fields What type of entry are you applying for?* Charity Entry ($1,500 required fundraising minimum) Registered/Qualified/Invitation ($500 required fundraising minimum) Virtual Entry/Walker ($500 required fundraising minimum) Event Preference* In-person Athlete Virtual/Walker Athlete SalutationMr.Mrs.Ms.Dr.NoneFirst Name*Last Name*Gender* Female Male Other I would prefer not to answer Address*City*State*Zip Code*Date of Birth*Cell Phone*Email Address* Employer*Title*Does your company have a matching gifts program?* Yes No Not Sure Are you affiliated with the Joe Andruzzi Foundation in any way (ie: Team JAF alumni, corporate partner, board member, volunteer, staff, relative or friend of someone working at JAF, etc.)?* Yes No If yes, how?How did you find out about running this event for Team JAF?* Asics Falmouth Road Race Website Team JAF Alumni JAF E-Blast JAF Social Media JAF Website Online Search Word of Mouth Other If other, please explain:Please describe why you would like to run for the Joe Andruzzi Foundation?*If selected, would you be willing to share this story via social or traditional media outlets?* Yes No Finish This Statement: I choose to run for JAF because...If selected, would you be willing to share this statement via social or traditional media outlets?* Yes No Team ApparelPlease note, runners are required to wear the Team JAF race tank on race day. Please indicate men's or women's and preferred size below (S-3XL).Official Team JAF Race Tank*Social HandlesFacebook NameInstagram UsernameFundraisingIf selected for Team JAF, what is your fundraising commitment? (If selected this becomes your fundraising minimum) $500 (required minimum for registered/qualified) $1000 $1500 (required for charity athletes) $2000 $3000 $4000 Have you participated in an athletic charity program before?* Yes No If yes, what is the most recent event and how much money did you raise?What are your ideas for raising funds this year if selected?*RunningHave you ever participated in Falmouth?* Yes No If yes, how many years and what was the most recent? (include date)*There is a 1 hr 45 min time limit for the 7 mile race. Are you able to finish within these time limits?* Yes No I don't know Do you have any pre-existing injuries or medical conditions that may prohibit you from completing this race?* Yes No If yes, please explainEmergency Contact(Person listed cannot be running the Falmouth Road Race)Name*Relationship*Home Phone*Cell Phone*Allergies/ MedicationsTerms & Conditions* I have read through the terms and conditions and acknowledge if accepted to the team, I will be required to sign a document confirming I agree to these terms and conditions. * I agree to read through all terms and conditions from the Falmouth Road Race during this process. Signed*Date* MM slash DD slash YYYY
