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Team Esplanade Marathon Application 2010 - The Esplanade

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					Team Esplanade Application 2010 Boston Marathon® Charity Program
All pages of the application must be completed and returned by mail, fax, or email by November 1, 2009. If you have questions about the application or Team Esplanade, please don’t hesitate to contact Chris Murton by phone at 617-227-0365 or by email at cmurton@esplanadeassociation.org. Please print or type clearly. Send completed applications to: The Esplanade Association Attention: Team Esplanade 10 Derne Street Boston, MA 02114 Fax: (617) 227-0394 Email: marathon@esplanadeassociation.org

General Information
First Name ____________________ Last Name _________________________ DOB______________ Address ______________________________________________________________________________ City ______________________________________ Home Phone __________________________ Personal Email _________________________ Employer _____________________________ State ______________ Zip _________

Cell Phone _____________________________ Work Email _____________________________ Job Title______________________________________

Work Address _________________________________________________________________________ City ____________________________________ Work Phone___________________________ State______________ Zip___________

Fax___________________________________

Running Shirt: Men’s ____ Women’s ____ / Small ____ Medium _____ Large _____ Extra Large _____ Does your company have a matching gifts program? Yes ______ No ______ Unsure _______ Cell _______

I would like to be contacted at the following phone number: Home ______ Work _____

I would like to be contacted at the following email address: Home ____ Work ____ Other ____________

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Fundraising Goal and Plan
If you are a member of Team Esplanade, what will your fundraising goal be? (Note: The minimum fundraising level required to participate in the Boston Marathon charity program is $3,250, but we hope our runners will aim higher! The Esplanade Association will assist all runners in meeting their fundraising goals.) Goal: $___________ How do you plan to meet your goal (actions, strategies, events, etc.)? : ______________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ What challenges do you anticipate facing in your fundraising efforts? _______________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Fundraising Experience
Have you participated in a marathon/road race charity program before? Yes______ No______ If so, what charity program did you participate in and how much money did you raise? Charity program: __________________________ Amount raised: $___________

How did you raise this money?_____________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Please list any other relevant fundraising experience: ____________________________________________ _____________________________________________________________________________________ Do you have any fundraising commitments over the next six months? ______________________________ _____________________________________________________________________________________ What is your comfort level in soliciting donations on behalf of a charitable organization such as The Esplanade Association? Very Comfortable____ Somewhat Comfortable____ Not Comfortable_____

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Team Esplanade and The Esplanade Association
Why would you like to run with Team Esplanade? _____________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ How did you learn about The Esplanade Association? __________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Are you a member of The Esplanade Association? Yes______ No______

Have you had any experience with any of The Esplanade Association’s programs? Yes______ No______ If yes, which programs in and what capacity? _________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ How do you see yourself becoming involved with The Esplanade Association after the Marathon? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Running Experience and Other Information
Please answer the following questions so that we can get to know you better. While no previous running experience is necessary to join Team Esplanade, we want to be sure that you’re physically capable of completing the Marathon safely. What is the number of previous marathons that you have run? ____________________________________ How many previous Boston Marathons have you run? __________________________________________ Typical training pace: minutes per mile: ______________________________________________________

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What is the longest distance that you have run: ________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Are you applying to run the 2010 Boston Marathon with any charities other than The Esplanade Association? Yes______ No______

If so, which organizations? _______________________________________________________________ _____________________________________________________________________________________ Beginning on November 21, Team Esplanade will gather every other Saturday morning for group training sessions, and will meet Saturday, November 14 for the first of our monthly team meetings. Do you foresee any conflicts in attending these meetings? (Note: Attendance at the Team Esplanade kickoff and two of the first three training sessions is mandatory, with few exceptions. Please see the Terms and Conditions for details.) Yes______ No______

If yes, what is the reason? ________________________________________________________________ _____________________________________________________________________________________ Hobbies/ Sports/ Interests/ Community/ Volunteer activities: ___________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Is there anything else that you’d like us to know? ______________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

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Team Esplanade Applicant Terms and Conditions For the 2010 Boston Marathon® Charity Program

Please carefully read the following before signing below.
Our Commitment to You: The Esplanade Association, as an official charity of the Boson Marathon, is honored by your interest in running with Team Esplanade. While we require a substantial commitment of time, energy, and enthusiasm from our runners, we feel strongly that we need to provide our runners with even more. We will offer as many resources as possible to help you achieve your running and fundraising goals, and commit to providing members of Team Esplanade with the following:         An official waiver entry into the 2010 Boston Marathon; Professional training, nutrition, and sports psychology coaching from team coach Rick Muhr and other marathon experts; Training and race day running gear, including a high-performance training shirt and a Team Esplanade racing singlet; Entry into multiple long-distance training runs; Fundraising support and strategy from The Esplanade Association staff; An online fundraising platform for electronic donation solicitation; Access to official Boston Marathon events; Access to a finish line celebration on Marathon Monday.

The Esplanade Association will strive to make the training, fundraising, and overall Boston Marathon experience as meaningful, fun, supportive, and empowering as possible for all of our runners, and we thank you for your interest in running with Team Esplanade. Fundraising Commitment for Waiver Runners: A minimum fundraising commitment of $3,250 is required to join The Esplanade Association marathon team as a waiver runner. If you are selected to the team as a waiver runner, you are contractually obligated to meet this minimum by April 26, 2010. Half this amount ($1,625) is due by February 1, 2009, as demonstration of your commitment to Team Esplanade. Deposit: A non-refundable deposit of $300 will be charged to your credit card if you accept a space on Team Esplanade as a waiver runner. $250 of this deposit is applied to the Boston Marathon entrance fee required of every runner; $25 is applied to administrative costs associated with the management of Team Esplanade; and $25 is applied to your fundraising effort. This deposit is mandatory, and will hold a Boston Marathon waiver until Recommitment on February 1, 2010. The $3,250 fundraising commitment and $300 deposit are the only financial commitments required of Team Esplanade runners. Personal expenses associated the Marathon (i.e. shoes, energy bars, etc.) are not covered by these commitments, and are the responsibility of the individual runner. Credit Card Information: Valid credit card information must be included with your application to apply for a space on Team Esplanade. If you are unable to reach the fundraising deadlines of February 1, 2010, and April 26, 2010, as mentioned above, The Esplanade Association reserves the right to charge the balance owed to your credit card, unless alternative arrangements have been made. MasterCard, Visa, and American Express are accepted. We will not charge your credit card until you have accepted a spot on Team Esplanade. Attendance Policy: All members of Team Esplanade are required to attend the Team Esplanade Kickoff Meeting on November 14, 2009, the Training Kickoff on November 21, 2009, and either the second or third training runs on December 6, 2009, or December 19, 2009, respectively. All runners are encouraged to

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attend every team meeting and training session throughout the training process. Non-attendance without advanced notice and approval will be cause for forfeiture of your space on Team Esplanade. A full calendar of dates and events will be provided to individuals upon acceptance to the team. If you are an applicant who lives outside of the Boston metropolitan area, please contact The Esplanade Association to discuss your involvement with the team. Cancellation Policy: You may cancel your participation with The Esplanade Association team for the Boston Marathon, waiving your responsibility for the $3,250 minimum anytime on or before January 2, 2010. To do so you must contact The Esplanade Association, in writing, on or before the cancellation date. Your $300 deposit is non-refundable, though you may receive a maximum of $250 in refund once a replacement runner has been found. After January 2, 2010, you are responsible for raising the $3,250 minimum, even if you are unable to run the Boston Marathon in the event of injury, illness, etc. Donations raised and received by our office will not be refunded, even if you cancel before January 2, 2010. Injury Policy: If you are injured after January 2, 2010, and are not able to train and participate in the Marathon, you must still meet the minimum fundraising commitment of $3,250. However, in this situation you are immediately eligible to run the 2011 Boston Marathon as a waiver runner, and are not obligated to fundraise for a charity such as The Esplanade Association in order to receive this waiver number. In the event that you choose to accept this deferral, you must pay the Boston Marathon entrance fee in 2011 in order to receive a waiver number. Matching Gift Policy: Many companies match employees’ charitable contributions. Any and all matching gifts granted on behalf of your fundraising efforts will count towards your fundraising minimum. You can check with your employer to see if your company has this program, and ask donors if their employers match gifts. Many companies issue matching gift checks quarterly or semi-annually: therefore if you plan to use a match to reach your minimum, it is your responsibility to contact the matching company to ensure the check will be issued before April 26, 2010.

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Release Form and Contribution Agreement Contract: In consideration of my accepting this entry, I hereby for myself, my heirs, executors and administrators, waive and release any and all rights for claims and damages I may have against The Esplanade Association, its employees, volunteers, officers and sponsors for any and all injuries suffered or sustained by me in said event, in the training and planning sessions for said event, or travel to or from any of the preceding. I further attest and certify that I am physically fit and have sufficiently trained for competition in this event, and a licensed medical doctor has verified my physical condition. I also grant permission for use of my name and or photograph or voice in broadcast, telecast, print or any other account of this event and agree to waive any compensation for such use. I agree to collect a minimum of $3,250 for The Esplanade Association by April 26, 2010, and to abide by the recommitment policy stated above. If I have not raised $3,250 by April 26, 2010, I will personally be responsible for the balance owed unless prior arrangements have been made with The Esplanade Association. I understand that unless I cancel by January 2, 2010, The Esplanade Association reserves the right to charge the balance owed towards the $3,250 minimum to my credit card after April 26, 2010. I declare that I have exercised my own judgment in signing this agreement and I further declare that the decision to sign this agreement was voluntary and not based on or influenced by any representation of The Esplanade Association. Signature: ____________________________________ Credit Card Information: Mastercard ______ Visa ______ American Express ______ Expiration Date: ________________________ Date: _________________________________

Card Number: _________________________________

Name on Card: _______________________________________________________________________ Address (if different from address on page 1):_________________________________________________ _____________________________________________________________________________________ Signature of Card Holder:________________________________ Date:______________________

Medical Release: In the event of an illness, injury or medical emergency arising during the event or in the training and planning sessions for said event, I hereby authorize and give my consent to The Esplanade Association to secure from any accredited hospital, clinic and/or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment, and hospitalization. The following person should be contacted in the event of an emergency: Name_____________________________________ Home Phone____________________________ Relationship______________________________ Cell Phone:______________________________

Allergies to medications:__________________________________________________________________ Signature:___________________________________ Date:_____________________________

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