Team First Candle - 2022 TCS New York City Marathon Bib Sign Up Questionnaire

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Address

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* 4. Date of birth

Date

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* 5. Company Name

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* 6. Does your employer match charitable contributions?

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* 7. What is your fundraising goal?  Please note the minimum fundraising requirement is $3,000.

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* 8. Please describe why you want to run with the First Candle team.  We want to hear about your story and what makes you a great fit for our team.

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* 9. TERMS AND AGREEMENT: 

  • If my application is approved, I agree to provide credit card information as a personal guarantee for my fundraising minimum of $3,000.
  • If my application is approved, I agree to allow First Candle, their partners and media outlets to share my story, use my image, likeness and video for promotional purposes.

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* 10. I agree to the following First Candle Waiver:

In consideration of being permitted to participate in Team First Candle, I do hereby, for myself, and heirs and personal representatives, release and discharge First Candle, Event organizers and their affiliates, agents, employees, officers, directors, successors, assigns, and all other persons connected with this program, from any and all liabilities on account of any injury, death, or damage of every kind growing out of my participation in any of the Events, whether caused by their negligence or otherwise, I am physically fit and sufficiently trained to participate in the Events and recognize the risks involved, and intend by this release to assume full responsibility for anything that might happen to me. I understand that if the Event is cancelled because of circumstance beyond the control of the Event directors or First Candle, including but not limited to hazardous weather condition or government ban, my registration fee for First Candle will not be refunded. I grant full permission to First Candle to store, use, and/or reproduce my image or likeness by any audio and/or visual recording technique (including electronic/digital) now in existence or hereafter invented, for any legitimate purpose including sales and marketing purposes. I have carefully read this release and fully understand its contents. I am aware that this is a release of liability between myself and First Candle and its affiliated organizations.

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