Thank you for your interest in joining the Sanctuary for Families Bike Team. On Sunday, May 1, 2015, the team will represent Sanctuary in the TD Bank Five Boro Bike Tour, raising awareness and funds for our work.
Team-members are provided with guaranteed entry into the 2016 TD Bank Five Boro Bike Tour in exchange for a commitment to raise a minimum of $2,000 to support Sanctuary’s work providing essential services to victims of domestic violence, victims of sex trafficking, and their children.
Please e-mail your completed application and signed Terms and Conditions document to . Sanctuary will contact you within a week of submission to confirm your participation. Please note that due to the large number of applications, we regretfully cannot guarantee a slot on the Team to all applicants.
BIKER INFORMATION:
Today’s Date:
First Name: Last Name:
Address:
City: State: ZIP:
Email:
Primary phone: Secondary phone:
Birth date: Gender:
Employer:
How did you learn about Sanctuary for Families?
How did you learn about the Sanctuary for Families Bike Team?
Why are you interested in biking as part of our team?
How many times have you participated in the TD Bank Five Boro Bike Tour or another similar biking event?
Is there anything else you would like to share about your interest in joining the team?
Unisex T-shirt Size (check one): Small Medium Large XL
FUNDRAISING QUESTIONS:
***All participants must raise a minimum of $2,000 to support Sanctuary for Families***
What is your personal fundraising goal?
How do you plan to reach your fundraising goal?
Have you ever raised funds for an athletic event before?
Does your employer match charitable contributions?
Thank you for your support! Sanctuary for Families will contact you shortly after submission to confirm your placement on the team.
Questions? Email or call Jonathan Goodman, Manager of Special Events, at 212.349.6009 x494.
For more information about Sanctuary for Families, please visit www.sanctuaryforfamilies.org.
Join Sanctuary’s online community:
www.facebook.com/sanctuaryforfamilies
www.twitter.com/sffny
Sanctuary for Families Bike Team
Terms and Conditions - Please Read Carefully & Sign
Fundraising Commitment: A $2,000 minimum fundraising commitment is required to join the Sanctuary for Families Bike Team and receive an entry for the 2016 TD Bank Bike Five Boro Tour which will take place on Sunday, May 1, 2016.
Valid credit card information must be included with your application to apply for placement on the Sanctuary for Families Bike Team. In the event that you do not meet the minimum donation requirement by Sunday, May 8, 2016, Sanctuary for Families reserves the right to charge the balance owed to your credit card.
Cancellation Policy: If for some unforeseen reason you need to withdraw from the Sanctuary for Families Bike Team, we ask that you abide by the following terms:
· If you withdraw any time on or before Friday, April 1, 2016, Sanctuary for Families will waive your responsibility for the $2,000 minimum and you will incur no fees.
§ If you withdraw after Friday, April 1, 2016 for any reason, including injury, you are responsible for the $2,000 minimum fundraising commitment.
In order to cancel, please contact Jonathan Goodman, Manager of Special Events, at Sanctuary for Families, in writing, on or before Friday, April 1, 2015.
* Please note: Donations raised and received by Sanctuary for Families will not be refunded, even if you cancel before Friday, April 1, 2015.
Matching Gift Policy: Many companies match employees’ charitable contributions. We encourage you to check with your employer to see if your company has a matching gift program, and ask your donors if their employers match gifts. It is your responsibility to contact the matching company to ensure the matching gift form will be issued before Sunday, May 8, 2015. If Sanctuary for Families does not receive the matching gift form prior to Sunday, May 8, 2015 the match cannot count toward your minimum fundraising goal.
Liability Waiver, Release Form and Contribution Agreement:
• I know that participating in the TD Bank Five Boro Bike Tour is a potentially hazardous activity. I understand that I should not enter the TD Bank Five Boro Bike Tour unless I am medically able to do so. I am voluntarily entering, and I assume all risks associated with training for and biking in this event, including any of the following, whether occurring during training or during the event: bodily injuries, death, property damage, falls, spills, contact with vehicles or other participants, the effects of weather, traffic and course conditions, and all other conditions, foreseen or unforeseen, all such risks being understood and accepted by me.
• Having read and understood this waiver, and in consideration of the acceptance by Sanctuary for Families of me as a member of the Sanctuary for Families Bike Team, I, for myself and my legal representatives, successors, heirs, assigns, executors and administrators, do hereby waive, release and discharge Sanctuary for Families and its officers, directors, agents, employees and other representatives from all present and future claims and liabilities of any kind, known or unknown, foreseen or unforeseen, arising out of, resulting from or in any way connected with my training for or participation in the TD Bank Bike Five Boro Bike Tour.
• I hereby grant permission to Sanctuary for Families to use my name and/or photograph, voice or other likeness in broadcast, telecast, print or any other account of this event for any legitimate purpose.
• I agree to abide by the rules of the TD Bank Bike Five Boro Bike Tour as stated in all official bike tour information.
• I agree to collect a minimum of $2,000 for Sanctuary for Families by Sunday, May 8, 2016. If I have not reached the minimum sponsorship by that date, I will be personally responsible for the balance owed.
• I understand that if I cancel after Friday, April 1, 2016, Sanctuary for Families reserves the right to bill any unearned portion of the $2,000 minimum commitment to my credit card on the date of my cancellation.
• I agree that if the TD Bank Bike Five Boro Tour does not take place for any unforeseen circumstance, any funds raised by me will not be refunded.
CREDIT CARD INFORMATION:
Cardholder’s Name:
Credit Card Type: American Express Visa MasterCard Other
Credit Card Number:
Expiration Date:
By signing below, you agree to all terms and conditions set forth herein, and authorize Sanctuary for Families to charge your card in the event that you do not fulfill your fundraising commitment.
______
Applicant’s Signature Date
P.O. Box 1406 Wall Street Station New York, NY 10268-1406
Tel: 212-349-6009 Fax: 212-349-6810
www.sanctuaryforfamilies.org