2021 TCS New York City Marathon Application - Special Olympics Massachusetts

Please be sure to fill in all of the information requested below. A Special Olympics Massachusetts representative will be in touch with next steps if your application is selected to move forward.

Contact Info

Please select your participation type:*

2021 Charity Invitational Runner
2021 Qualified Runner
2021 Other Runner

"Charity invitational runners" will intend to receive a bib from Special Olympics Massachusetts and will commit to raise a $5,000 minimum. "Qualified runners" & "Other runners" are runners who have secured a bib from another source - These two types should email xtramile@specialolympicsma.org for further fundraising details.

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone*

Email*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Name of Employer*

Work Title*

Work Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone

Work Fax

Does your company have a matching gifts program*

Yes
No

I Would like to be contacted at:*

Home
Work

Endurance T-Shirt Size*

Small
Medium
Large
Extra Large

Racing Shirt Size*

Fundraising Experience

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

Yes
No

If Yes, Which Charity?

And How much did you raise?

What will Your Fundraising goal be for Special Olympics Massachusetts?*

There is a mandatory $5,000 minimum for charity invitational runners; however, we strongly encourage participants to raise $8,000. *Each runner is responsible for their own race registration fee when they register for the marathon. It does not apply towards your fundraising.

Additional Questions

How did you learn about Special Olympics Massachusetts/How are you connected to Special Olympics?*

Why you would like to run for Special Olympics Massachusetts?*

Upload a picture(s) of yourself running or in running gear

Drop files here or

Max. file size: 50 MB.

If accepted to the team, we'll be using this photo to announce our 2020 team via email, social media, and other outlets.

Signature - Print Name*

By entering my name, I agree to fundraise a $5,000 minimum for Special Olympics Massachusetts if selected for the team, and agree to the liability and fundraising terms and conditions set forth by Special Olympics Massachusetts

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