Registration Info for Back on My Feet Baltimore Boston Bib #@ID1@

Company

Date of Birth

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Relation to Runner

T-Shirt Size Make a selectionMen's SmallMen's MediumMen's LargeMen's Extra LargeMen's Extra Extra LargeWomen's Extra SmallWomen's SmallWomen's MediumWomen's LargeWomen's Extra Large

Jacket Size Make a selectionMen's SmallMen's MediumMen's LargeMen's Extra LargeWomen's SmallWomen's MediumWomen's LargeWomen's Extra Large

What does running on behalf of Back on My Feet Baltimore mean to you?

I agree to raise 50% fundraising ($3,750) by February 15, 2019

I agree to raise 80% fundraising ($6,000) by March 31, 2019

I agree that if I have not raised the fundraising minimum of $7,500 by April 15, 2019, I authorize Back on My Feet to charge my credit card the amount required to reach the fundraising minimum or the bib may be pulled at the discretion of Back on My Feet.

I agree to the PARTICIPANT'S AGREEMENT, WAIVER, RELEASE AND ACKNOWLEDGEMENT on baa.org and I confirm Back on My Feet is not liable for any injury sustained.

Yes I agree to the above