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“Fundraising for Registration” Guaranteed Race Entry Commitment
and Credit Card Authorization Form
I am committing to raise funds for The Parish School for the 2015-16 Run for a Reason campaign to
secure a guaranteed entry into my selected race (check below). After I pay the registration fee and
raise half of the minimum amount by Monday, November 16th, I will register myself into the race
with a link and code provided by The Parish School’s charity administrator.
I wish to register for the: ☐ Chevron Houston Marathon
☐ Aramco Houston Half Marathon
In the event the minimum $250.00 is not raised by Monday, November 16, 2015, I understand that
I will make my own donation to reach this amount. I therefore permit The Parish School to charge
my credit card for the remaining fundraising difference.
In the event the minimum $500.00 is not raised by Wednesday, January 20, 2016, I understand
that I will make my own donation to reach this amount. I therefore permit The Parish School to
charge my credit card for the remaining fundraising difference.
I understand The Parish School will send me the registration link and code and I will register for the
race no later than one week after I have received my registration link and code from The Parish
School’s charity administrator.
I understand there will be no refunds. If I am unable to participate in the 2016 event, all money
raised will remain with The Parish School and cannot be counted toward a future race entry.
Registration fee for the full marathon:
Minimum amount to raise for the full marathon:
Minimum amount to be registered:
$135.00
$500.00
$635.00
Registration fee for the half marathon:
Minimum amount to raise for the half marathon:
Minimum amount to be registered:
$115.00
$500.00
$615.00
Credit Card Type: (please check one): ☐ VISA
Credit Card Number:
☐ MASTERCARD
Expires:
☐ AMEX ☐ DISCOVER
Security Code:
Name (as it appears on the card):
Billing Address:
street
Email:
city
state
Primary Phone:
Signature:
Date:
The Parish School | 11001 Hammerly Blvd., Houston, TX 77043 | O: 713.467.4696 | www.parishschool.org
zip