Name:                

Mailing Address:

Phone:                

E-mail:               

Full marathon:         Half marathon: 

Type: Walk Run Combo       T- Shirt Size: Small Medium Large XLarge XXLarge

I, (please type name) have read and understand the eligibility and participant requirements for participation in the TEAM TEMPE Training Team.  I confirm that I am in good health and/or have received my physicians permission to participate in this program (please initial here). 

I agree to raise a minimum of $300.00 for TEAM TEMPE. Enclosed is my initial personal donation of $40.00 which will be applied toward my fundraising goal (please make check payable to Tempe Community Council and send to:  34 E. 7th Street, Tempe, AZ  85281).

I further understand that as a Participant of the TEAM TEMPE Training Team, my name, and or photo may be published in media articles, ads or reports. 

Signed        Date:                  
             (Participant)

Signed        Date: 
             (Parent/Guardian if under 18 – may participate in ½ marathon only)

(Please note:  Names and initials entered into the fields above are considered electronic signatures and are legally binding.)