2015 Challenge Aspen Training Team Fundraising Commitment

2015 Challenge Aspen Training Team
Auckland, New Zealand ASB Marathon & Half Marathon
Event Date: November 1, 2015
Fundraising Commitment Agreement
I understand that, as a member of the Challenge Aspen Marathon & Half Marathon & 10K Team, I
have agreed to fundraise $4,300 on behalf of Challenge Aspen. The total fundraising amount due
has been divided into the following payment schedule:
Dates
Upon Registration
5 weeks after Registration
July 1, 2015
October 5, 2015
Amount Due
$
150
$
500
$ 1,825
$ 1,825
Cumulative Total
$
150
$
650
$ 2,475
$ 4,300
At each payment date, I agree if I have not fundraised the total amount due I will be required to
secure the difference by either credit card or personal check.
CREDIT CARD #:
Exp. Date:
I agree to pay the balance of my fundraising requirement if I have not raised my goal amount
of $4300 prior to our travel departure date of October 27, 2015. I understand this amount will be
refunded to me as soon as donations are received by Challenge Aspen to meet my goal amount. I
may continue to fundraise up to three months after the marathon event (through February
1,2016C51647).
If I, for any reason, decide to drop out of the program, I am not obligated to raise any outstanding
amount. All funds raised to that point in time will go directly to Challenge Aspen and are nonrefundable.
Signature:
Printed name:
Date:
Are you interested in helping to coordinate social gatherings for the team?
2015 Challenge Aspen Training Team
Auckland, New Zealand ASB Marathon & Half Marathon
Event Date: November 1, 2015
Registration
Please type or print.
Full Name (as it appears on your PASSPORT):
Mailing Address:
City:
State:
Daytime Phone: (
Cell Phone: (
Zip:
Country:
Evening Phone: (
)
)
)
Best time of day to reach you?
Email Address:
Gender: M
F
Date of birth:
/
Training shirt size (circle): Women/Men
Employer:
/
XS
S
M
L
XL
XXL
Emergency Contact(s):
I intend to primarily: Walk
Run
in the Full Marathon
Half-Marathon
Enclosed please find my $150 non-refundable check to secure my place on the Challenge Aspen
Marathon team. (Upon receipt, team information will be sent to your attention.) This will be applied
toward my fundraising and, if I request, will be refunded after my goal has been reached.
Please charge my $150 Registration Fee to my credit card:
CC#:
Exp Date:
Code:
I consent to allow Challenge Aspen to charge the above credit card for a $150 non-refundable
registration fee to participate in the 2015 Challenge Aspen Auckland Marathon Events. I
understand that this fee will be applied toward my fundraising total and, if I request, will be
refunded after my goal has been reached.
Signature:
Date:
For more information, contact:
Jenni Petersen - Challenge Aspen
PO Box 6639 Snowmass Village, CO 81615
Phone: (970) 923-0578
Email: [email protected] * Website: www.challengeaspen.org