Welcome to the TGLF
ING NYC Marathon Charity Program

ING NYC Marathon

By becoming a member of Team Labrecque, you commit to donate or raise funds of at least $2,500 for the Thomas G. Labrecque Foundation; a designated Charity Partner of the ING New York City Marathon 2011. Your credit card information is required as a guarantee against this pledge.

We require that half of your fundraising commitment is due by September 9, 2011. Fulfillment of your $2,500 commitment is due by Friday, October 14, 2011. If you have not submitted at least one-half of the minimum pledge of $1,250 by the close of business on September 9, your credit card will be charged for the amount of $1,250, less any payments received from your donors by that date. If your donations do not total the full minimum pledge of $2,500, your credit card will be charged on October 14, 2011 for the amount necessary to fulfill that pledge. (Any amount charged to your credit card will be considered a charitable donation and we will send you confirmation of this donation for tax purposes). This deadline is in place to ensure that every runner fulfills his or her fundraising commitment. If funds are not received by the deadline for any reason, you will forfeit the ability to participate in the 2011 ING NYC Marathon.

If you are unable to participate in the marathon due to illness, injury or conflict, you are obligated to raise at least half of the required $2,500 as set forth in this agreement. Please note that donations will not be refundable if the Fundraiser does not participate in the marathon but will count towards next years fundraising goal (for the 2012 ING NYC Marathon).

  

(Asterisk * denotes REQUIRED field)

First Name: *

Last Name: *

Date of Birth: * mo/day/year

(00/00/00)

Gender: *

Male     Female

Address: *

Address Line 2:

City: *

State: *

Postal Code: *

Daytime Phone: * (Work)

E-mail Address: *

Chip Number:

Enter if you are using your OWN ChampionChip (numerals only-no dashes!). Non-chip owners will receive a chip with their running number.

NYRRC#:

Optional if you want the race to be included in your race history.

Jacket size [XS, S, M, L, XL] [Men / Women] (circle all that apply)
Shirt size [XS, S, M, L, XL] [Men / Women] (circle all that apply)
*please note, once we have ordered your size, you will be unable to exchange for another size

Payment Method

Fundraising Minimum $2,500
MC or Visa

 Mastercard      Visa    

Credit Card Number: *

Enter numerals only - no dashes or spaces. (No debit cards!)

Expiration Date: *(Month/Year)

  / 
 

Signature
 
Thank you for your participation!
Please print the form and fax to TGL Foundation
Fax 703-997-8907


TGL Foundation 1414 Prince Street, Suite 400, Alexandria, VA 22314
Telephone 703-299-9600

 
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