ASICS Falmouth Road Race Application

Status of Applicant:

I need a charity bib and agree to raise $1,000
I have my own bib, but want to join the team and agree to raise $500

Name*

First Last

Address

Street Address Address Line 2 City State ZIP Code

Date of Birth

Phone

Email*

Please choose a shirt size:*

Fundraising

Have you participated in a road race charity program before?*

Yes
No

Please list charity fundraising programs in which you participated (name, amount raised, year):

Charity Name	Amount Raised	Year

What is your fundraising goal?

$500—I have my own bib
$1,000—Charity bib minimum
Over $1,000—The sky’s the limit!

What are your ideas for raising these funds? Please be specific.

Getting to Know You

Are you affiliated with DetecTogether in any way? (member, corporate member, board member, volunteer, staff, relative or friend)

How did you learn about the team?

Why you would like to run for DetecTogether?

Have you or a family member been diagnosed with cancer? Please explain.

Allergies/Medications

Any there any other situations we should be aware of that may impact your ability to train, finish or fundraise for this event such as past injuries?

Terms and Conditions*

Registration: You will receive your race registration after your application is accepted on Team DetecTogether.

Release Form and Contribution Agreement: In consideration of you accepting this entry, I, the participant, intending to be legally bound, do hereby waive and forever release any and all right and claims for damages or injuries that I may have against DetecTogether, and, to the maximum extent permitted by law, all of their agents assisting with the event, coaches, sponsors and their representatives, volunteers and employees for any and all injuries to me in said event and in the training and planning sessions for said event or travel to and from any of the preceding. This release includes all injuries and/or damages suffered by me before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees. This release shall not apply to any entity wherein a release is prohibited by law.

I certify as a material condition to my being permitted to participate in this event that I am physically fit and sufficiently trained for the completion of this event and that a licensed Medical Doctor has verified my physical condition. Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, video graphic or electronic recording of this event for legitimate purposes and agree to waive any compensation for such use.

I agree to collect a minimum of $1,000 for DetecTogether by race day, Sunday, August 18, 2024. If I have not reached the amount in donations by that date, I will personally be responsible for the balance owed. 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. I understand that DetecTogether discourages any bib pick up until the fundraising minimum obligation is met.

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

I understand all the terms and conditions of my participation in the 2024 program. I am confirming the information listed in the my application is accurate. I have also noted the due date for material submission and fundraising goals. I understand that the submission of this application does not guarantee me a spot on the team.