2022 Falmouth Road Race Runner Interest Form, May Institute

Thank you for your interest in running on behalf of May Institute in the Falmouth Road Race on Sunday, August 21 in Falmouth, OR as part of the At-Home Virtual Race between August 7-14!

As part of #TeamMay, you are willing to raise a minimum of $750 for children and adults with autism, brain injury, and other special needs.

Upon receipt of your Interest Form, the May Institute Philanthropy Office will send you a Commitment Form for you to return to us. If you have any questions or concerns, please do not hesitate to contact Eileen Pollack at epollack@mayinstitute.org or (781) 437-1368.

We look forward to having you on #TeamMay!

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* 1. Please provide us with your contact information

Name: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *

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* 2. What is your affiliation to May Institute?

Employee at May Institute

Parent/relative of someone who attends May Institute

Friend of an employee at May Institute

Friend of family who has a child/relative who receives services at May Institute

May Institute donor

Don't know anyone who is affliated with May Institute, but I would like to run to support children and adults with autism, brain injury, and other special needs

Other

Other (please specify)

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* 3. This year, runners have the option to run in person in the race on race day, OR participate in the At-Home Edition virtual event! Which one would you like to do?

In person on August 21 in Falmouth!

In the At-Home Edition virtual event in August!

I'm not sure yet

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* 4. As a runner, you will receive a "Team May" running jersey. What size shirt would you like?

	X-Small	Small	Medium	Large	X-Large	XX-Large
Men	Men X-Small	Men Small	Men Medium	Men Large	Men X-Large	Men XX-Large
Women	Women X-Small	Women Small	Women Medium	Women Large	Women X-Large	Women XX-Large

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* 5. Why do you want to run for May Institute?

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* 6. Are you running for a specific program at May Institute or would you like for the funds you raise to support the greatest needs of the organization? Please type what program you would like to support or "Greatest Needs."

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* 7. By checking this box, you agree to raise a minimum of $750 and to submit those donations to May Institute by race day.

I agree to raise at least $750 by Sunday, August 21, 2022.

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* 8. I understand that after completing this form, I will receive a Commitment Form in the mail that I must return to May Institute in order to officially join #TeamMay. I also understand that I will have to complete one additional online form through the Falmouth Road Race's website. This website and code will be emailed to me after I return the Commitment Form to May Institute's Philanthropy Office.

Yes

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* 9. I would like to share my email address with other May Institute runners.

Yes