Yes! I want to run with Team FPWR in the 2016 NYC Marathon!

Please complete all questions to the best of your ability. If you are one of 5 lucky runners selected in the random draw, all biographical information provided may be used for public promotion of your participation in Team FPWR. Contact information will be used solely for the purpose of communicating with you about this opportunity and, if awarded a bib, training and fundraising pertaining to the 2016 TCS New York City Marathon. Thank you!

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* 1. Your Contact Information

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* 2. What is your age?

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* 3. What is your gender?

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* 4. What is your relationship to Prader-Willi syndrome?

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* 5. Please tell us why this opportunity is important to you. If awarded a bib, this response may be used publicly.

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* 6. Please provide a brief bio (300 words or less). If awarded a bib, this response may be used publicly.

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* 7. By applying for a bib with Team FPWR, I commit to raising a minimum of $5,000 by September 8, 2016.  All funds raised are direct donations to the Foundation for Prader-Willi Research, a 501c3 non-profit corporation, federal Tax ID#31-1763110. I agree to provide contact information and donor names for any donations given directly to me in the form of checks or cash. I will be provided with a fundraising web page that will allow me to raise funds online and ask my contacts to set up fundraising pages on my behalf.

If I do not raise a minimum of $5,000 by September 8, 2016, my credit card on file will be charged on September 10, 2016 for the remainder of funds to be raised. FPWR will send me a tax receipt for this donation. I may not forfeit my bid because of a lack of funds raised, nor may I pledge to make payments on this donation after the date of September 8, 2016.

If selected, I agree to provide my credit card information within 48 hours of notification of my selection.

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* 8. I understand that FPWR is conducting a random draw for 5 charity bibs for the 2016 NYC Marathon. I understand that in case of injury or need to withdraw from the marathon for any reason, all funds already raised will remain with FPWR. No donations may be returned to the donor for any reason. Additionally, I understand that I may not transfer my race bib to another runner. Per New York Road Runner rules and regulations, a replacement runner may be selected by FPWR, following an additional application process and fee payment by the Foundation. 

I am committed to training for the 2016 NYC marathon and believe that, as of today, I am putting my best effort into preparing for this strenuous physical challenge.

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* 9. If awarded a bib, I agree to complete a Team FPWR participant survey within 48 hours of receipt. I will correspond regularly with FPWR staff and volunteer training and fundraising coaches. I also agree to provide a photograph and biographical information to be used in public promotion of my participation with Team FPWR.

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