SUNDAY, MARCH 20, 2016
Thank you for your interest in joining Team MCC!
A limited number of guaranteed entries to the NYC Half are available and we would love to have you on our team. To be considered for an entry, each runner must commit to make a donation or raise funds totaling $1,000 or more to the Manhattan Childrens Center.

General Information
First & Last Name: ______________________________________________

Address: ______________________________________________________

Phone Number: ___________________Date of Birth: __________________

Email: ________________________________________________________
Fundraising Goals
By joining Team MCC and receiving guaranteed race entry, you are committing to raising at least $1,000, due not later than 2 weeks after the race, or April 6, 2016. We encourage all charity runners to set a fundraising goal above this minimum. We'll help you set up with an easy-to-use online fundraising tool.
What is your Fundraising Goal? $______________
Payment Information

All charity runners must guarantee the $1,000 fundraising minimum with a credit card. If you have raised less than $500 by March 11, 2016, two weeks before the race, we will charge your credit card an amoutn equal to $500 less the amount raised. The full $1,000 donation minimum must be met by April 6, 2016, two weeks after the race. The amount charged will equal $1,000 less the amount raised. If you join the team but drop out after February 18, 2016, you will be charged $1,000 less the amount raised.

   Type of Card: ☐ Visa ☐ MC ☐ AMEX

   Account Number: ______________________________________

   Exp Date: ______________ Name on Card: _________________

   Signature: ____________________________________________