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ASICS Falmouth Road Race Application

This field is for validation purposes and should be left unchanged.

Division/Fundraising Level

Nonprofit Runner:
$2,000 Fundraising Minimum
Includes a complimentary pre-paid entry into the Falmouth Road Race.

I Am Applying As A…*
Are you applying as a part of the Wheelchair Division?*

Personal Information

Name*
Address*
Gender*

Are you a student?*
Every runner on our team will receive a race day singlet to represent our team.

Prior Involvement

Have you participated in a Reach Athlete event before?*
Please indicate races or events you have participated in as a Reach Athlete.*
Use the plus and minus buttons on the right to list as many as you see fit
How did you hear about Reach Athletes and this application?*
Please select all that apply.

Why Reach Athletes?

Fundraising Experience

Have You Participated in a Charity Road Race Program Before?*
Please List The Races and Amount Raised*
Use the plus and minus buttons on the right to list as many as you see fit
Race Name
Amount Raised
 
Please List Any Other Prior Fundraising Experience*
Use the plus and minus buttons on the right to list as many as you see fit.
Event
Amount Raised
Date
 
The required fundraising minimum for all Family Reach runners in the ASICS Falmouth Road Race is $2,000. What is your Fundraising Goal?
Does your company have a corporate matching program?*
Please note company matches received after the fundraising deadline will not count towards your fundraising minimum. For more information, please see our Release Form and Contribution Agreement at the bottom of this page.
Which Forms of Social Media are you Active on?*
Use the plus and minus buttons on the right to list as many as you see fit. If none, enter n/a into both fields.
Social Media Network
Account URL / @ Handle
 
At some point during the season it is encouraged that our team host a fundraising event together. Could you commit to participating and supporting a team event?*

Running Experience

Have you run the Falmouth Road Race before?*
Please list the years you have run the Falmouth Road Race and your approximate finish times*
Use the plus and minus buttons on the right to list as many as you see fit
Year
Finish Time (approx)
 
Is this your first race of 7 Miles or longer?*
Please list any other marathons you have run in the past*
Use the plus and minus buttons on the right to list as many as you see fit
Race Name
Year
Finish Time (approx)
 
Do You Belong to a Running Club*
Please List Running Clubs in Which You Are a Member*
Use the plus and minus buttons on the right to list as many as you see fit
Do You Have Any Pre-Existing Sports Injuries?*
Do You Have Any Allergies or Medical Conditions*

Emergency Contact

Name*

Legal

Please read and agree to the Reach Athlete Release Form and Contribution Agreement HERE
Consent*
I have read and agree to the Reach Athlete Release Form and Contribution Agreement and verify that all information contained in this application is true and accurate.
Signature*
MM slash DD slash YYYY

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