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Camp Kita
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Boston Marathon Application
2016 Camp Kita Boston Marathon Application
Camp Kita is honored to participate in the Boston Marathon John Hancock Non-Profit Program.
If you are interested in joining our team at the 2016 Boston Marathon please complete the following application.
Basic Information
Name
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First
Last
Phone Number
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-
-
Email Address
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Gender
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Male
Female
Date of Birth
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How I heard about Camp Kita
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Application Type
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I have secured an official entry from another source.
I am B.A.A. Qualified and have secured an official entry through the B.A.A
I need a number from Camp Kita
My Motivation:
I heard about Team Camp Kita From:
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My Personal Experience with Camp Kita. (You have my authorization to use this information for media, promotions, etc.) :
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I would like to run for Camp Kita because:
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Fundraising
My personal fundraising goal for Team Camp Kita 2016:
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While the required fundraising minimum is set at $7,500 per runner, we encourage team members to set a higher personal goal to help achieve a 2016 Camp Kita goal of $30,000.00 Aim high and you will be amazed at what you can achieve! The 2015 John Hancock Non-Profit Parnership average raised was $9,500.00
my geographical area:
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My company plans to support Camp Kita
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Yes, my company participates in a matching gift program
Yes, my company plans to support Team Camp Kita through a corporate sponsorship
No, my company does not plan to support my participation with Camp Kita
other
details
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I plan to raise funds for Camp Kita through the following methods:
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Potential donors (describe in detail):
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My other (athletic and non-athletic) charity participation and fundraising results:
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Running Expereince
My running level
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Beginner
Intermediate
Advanced
Current weekly running mileage:
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Typical training pace (mins per mile):
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Number of previous Boston Marathons I have run:
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Number of previous marathons (anywhere) I have run:
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Best marathon time/location/date
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Additional Information
Social media networking sites I use:
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Facebook
LinkedIn
MySpace
Twitter
other
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I have a blog:
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yes
no
if yes, please provide URL
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Hometown Newspaper
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My Hobbies/Sports/Interests/Community/Volunteer activities:
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A note about myself - best run ever / biggest fan / toughest race / anything unique / extraordinary / obstacles overcome:
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My Unisex Shirt Size
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X-Small
Small
Medium
Large
X-Large
My Team Camp Kita Singlet Size:
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Terms and Conditions
2016 Camp Kita Fundraising Commitment
I understand that all funds raised will support Camp Kita and that an additional Boston Marathon Application (B.A.A.) fee of $350 will also be required, payable to the Boston Athletic Association (to be paid at a later date). The B.A.A. application fee does not count toward my total fundraising amount.
I agree to collect a minimum of $7,500 by April 16, 2016 to support Camp Kita as part of Camp Kita Team 2016.
I understand that Camp Kita reserves the right to charge my credit card for the balance I owe if I have not submitted the entire amount on or before April 16, 2016, or if I withdraw from the program after January 1, 2016. If you continue to fundraise after your credit card has been processed with the remaining balance we will reimburse your card upon written request.
Cancellation Policy: I understand that I may cancel my participation with Camp Kita for the 2016 Boston Marathon, waiving my responsibility for the fundraising minimum stated above, any time on or before January 1, 2016 by contacting Morgan Mosher at Camp Kita in writing. I understand that any donations received by Camp Kita will not be refunded.
I understand that after January 1, 2016, I am solely responsible for raising or personally giving the entire fundraising minimum, even if for any reason, including injury, I am unable to run in the 2016 Boston Marathon.
I agree that I will not begin the race prior to the official start time; I will not compete in a manner which, in the judgment of the race officials, interferes with race operations or other participants; I will not reproduce or transfer my official bib number.
Registration: I agree to pay a $350 race application fee to the Boston Athletic Association. I understand that this does not count toward my fundraising minimum for Camp Kita. Camp Kita will inform me of the details of B.A.A. registration. This fee will be collected separately at a later date. I will not contact the B.A.A. directly to secure my number.
Liability: I will not hold Camp Kita responsible for injury or death related to training for, or participating in, the Boston Marathon as part of Team Camp Kita.
ALL SELECTED RUNNERS MUST RAISE THE MINIMUM FUNDRAISING BY APRIL 16, 2016
I fully understand and agree to the Terms & Conditions
*
yes
no
Electronic signature
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You agree your electronic signature is the legal equivalent of your manual signature on this application.
Submit your application
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