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BLUE CROSS BROAD STREET RUN

VOLUNTEER GROUP

Information Sheet

Early Submittal- Due by March 11, 2009



Group Name:



Contact:



Rec. Staff Contact (if applicable)



Mailing Address:



City State Zip



Home Phone: Work Phone:



Fax Number: Race Day Cell:



Shirt Order: ______Medium _____ Large _____X-Large XX-Large



2008 Group Assignment/Location:





(MAY BE REASSIGNED AS RACE NEEDS DICTATE)



Make stipend Payable to:



Please return your completed form to:



Philadelphia Department of Recreation

Attention: Dennis P. Gibson

Blue Cross Broad Street Run Volunteers

Capitolo Playground

900 Federal Street

Philadelphia, PA 19147



Forms may be faxed to: Dennis Gibson – 215-683-1885



Questions: Call 215-685-1883 or e-mail BSRVolunteers@yahoo.com



Once we have confirmed that your group will be participating, we will send you the link to

register your group information online. This will enable you to e-mail all members of

your group with race information/updates as they become available.



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