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: ____________________________________________
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