2015 OFFLINE (MAIL-IN) TEAM REGISTRATION PACKET

Transcription

1 2015 OFFLINE (MAIL-IN) TEAM REGISTRATION PACKET Instruction Sheet for the Team Spreadsheets Do NOT include Team Members who register online on the spreadsheet. The Excel spreadsheet can be downloaded from Do not use a spreadsheet from a previous year! You must have Microsoft Excel on your computer for the spreadsheet to work. If you have problems downloading the file, please contact teams@komenarkansas.org or call the Komen office To Download the Excel Spreadsheet: 1) Right click on the attachment 2) Select Save As, and save in your C: drive using a file name of YourTeamName.xls (example only: Pink Ribbons.xls) 3) Close file. Please contact teams@komenarkansas.org if you have problems at any point, or call the Komen office To Enter Team Information: 1) Open the Excel Spreadsheet file from your C: drive. This is to test and make sure you saved it correctly 2) At the bottom of the Excel spreadsheet you will see four (4) tabs. Click on the Shipping Information tab and fill in the requested information. This is VERY important! Make sure you are in cell A2 to begin. 3) Click on the Team Members Roster tab to begin entering your team members' information. Be sure to SAVE as you work! You don't want to do all that work for nothing. 4) The Phone Number field is formatted and all you have to enter is the numbers. 5) The Birth Date field is NOT formatted and should be entered as MM/DD/YYYY. 6) There are drop down tabs on the following fields to assist you in entering the correct information: Gender; Participation Type; Shirt Size; Breast Cancer Survivor; Komen Membership, and Complimentary Registration. 7) If your team member is purchasing Pink Postcards or Pasta Party tickets, please enter the quantity (not $ amount) in the appropriate fields. 8) If your team member has participated in the Fundraising, enter the dollar amount he/she has raised (but only if the money is being included with your Team Packet). 9) If your team member has contributed an additional donation, enter the dollar amount that they are contributing. 10) If your team member is using a complimentary code provided by Komen Arkansas, please use the drop down provided in the next to the last column of the spreadsheet titled Complimentary

2 Registration. Select Complimentary to indicate that the registration you are entering is a complimentary entry. (Child 5 and Under is now a Participation Type, but still free.) 11) The last column of the spreadsheet is the Total for each team member you are registering. This is the amount that the team member owes you for registration. It should calculate automatically. 12) Once you have finished filling out your Team Member Roster, you are ready to reconcile your team registration. Remember to save your work! To Reconcile Team Information: 1) Click on the Totals and Other Information tab. 2) Fill in the four (4) fields at the top of the spreadsheet: Team Name, Team Captain, Three Miles of Men Captain, and their phone number(s). 3) The rest of that spreadsheet contains totals for you to use on your reconciliation sheet. 4) If you have access to a printer, please print this page twice. Retain one copy for your records and send the other copy with your Team packet for processing. 5) Please print your Team Members Roster page to submit with your packet. Select Block F1 to AE (your last line) and click File, Print Area, Set Print Area to print only the necessary information. CAUTION: Do a File, Print Preview first to determine whether you need to make changes in File, Page Setup and that you are not printing blank pages. 6) your completed spreadsheet to teams@komenarkansas.org using Your Team Name in the subject line (example only: Pink Ribbons). Only submit a CD if you are unable to your spreadsheet. 7) Checks should be made payable to Komen Arkansas Race for the Cure. If at all possible, please have team members make their checks to one place (i.e. your company) and send one check with the registration information. 8) Mail Packing list, Reconciliation Form, check(s) and printed spreadsheet to: Susan G. Komen Arkansas Race for the Cure 904 Autumn Road, Suite 500 Or hand deliver to: 904 Autumn Road, 5 th Floor Monday Friday, 10 am 3 pm Offline packets must be postmarked or hand delivered no later than September 14, 2015 to allow for processing.

3 OFFLINE TEAM CAPTAIN CHECKLIST **Unsigned forms or no form for a participant will delay processing of your team!** One entry form for EVERY participant completed and SIGNED Forms and checks are separated (no staples, please). One team check is preferred. However, if there are multiple checks, please enclose in separate envelope within main envelope. Please do not include cash. Fundraising forms completed and enclosed Pink Postcard forms completed and enclosed Packing List & Reconciliation Form completed and reconciled with the spreadsheet totals Excel spreadsheet complete and saved as an.xls file; (an example of a file name would be Pink Ribbons.xls but use your team or company name in place of Pink Ribbons) Spreadsheet ed to teams@komenarkansas.org Packing list, Entry Form, Reconciliation Form, check(s) and printed spreadsheet mailed to Susan G. Komen Arkansas Race for the Cure 904 Autumn Road, Suite 500 (Please send via a carrier with tracking services if you would like verification that your packet has been received. We will not be able to acknowledge receipt.) Or hand delivered to: 904 Autumn Road, 5 th Floor Monday Friday, 10 am 3 pm T-Shirt Pick Up: Team Captains of Teams with OFFLINE members in Bryant, Benton, Little Rock, North Little Rock, Maumelle, Sherwood and points in between, will be notified of times, dates and location to pick up. Teams outside of this area will receive their boxes via FedEx. Offline packets are to be postmarked or hand delivered no later than September 14, 2015 to allow for processing.

4 OFFLINE TEAM MEMBER ENTRY FORM Guidelines: Each team member MUST have their own form. DO NOT register more than one person on an entry form. Team entries must be submitted through your Team Captain. TEAM ENTRY FORM NOT VALID WITHOUT PARTICIPANT S SIGNATURE. A signed form must accompany every entrant regardless of level of participation. Team Name_ Team Captain Team Deadline_ Last Name First Name_ Gender: Female Male Home Address City State_ Zip_ Date of Birth(MM/DD/YY) Evening Phone(_)_ _ Race T-shirt size: S M L XL XXL XXXL Kids for the Cure T-shirt size: S M L (Your registration fee is not payment or consideration for a race t-shirt, supplies of which are limited. Race T-shirts will be distributed on size and availability as long as supplies allow. Only 1,000 Kids for the Cure t-shirts and 3,000 3 Miles of Men t-shirts will be produced and are on a first come, first served basis. No substitutions will be made) Would you like to be recognized as a breast cancer survivor by receiving a complimentary pink cap and T-shirt? 1. CHOOSE ONE EVENT: 2015 Race Waiver and Release 5K Run/Walk Competitive Run (Run 5K in 30 mins or less. Chip Timed) Family 2K Fun Walk/Run Kids for the Cure (Participant will receive a Kids shirt) Sleep in for the Cure Three Miles of Men (Participant will receive 3MOM t-shirt) Child under 5 (No fee, no t-shirt) 2. FEES, TICKETS, TRIBUTES, MEMBERSHIP: $ $25 Team Member Registration $ $35 Competitive Run Registration (5K in under 30 minutes) $ Pasta Party Tickets (# of tickets x $25) $ Pink Postcard Tribute (#x $5) (please include form) $ FundRaising Program $ Komen Foundation Membership Annual Member $35 Patron Member $100 Lifetime Member $1000 $) TOTAL 3. SIGNATURE (REQUIRED) _ Participant s Signature Date Parent or Guardian s Signature if under age 18 PHOTOGRAPHIC AND RESULTS RELEASE and WAIVER AND RELEASE OF CLAIMS. I AGREE THAT ANY AND ALL REPRESENTATIONS MADE AND RELEASES, WAIVERS, COVENANTS, CONSENTS AND PERMISSIONS GIVEN BY ME HEREUNDER ARE GIVEN ON BEHALF OF ME AND ANY AND ALL OF MY MINOR CHILDREN OR PERSONS OVER WHOM I HAVE GUARDIANSHIP PARTICIPATING IN OR ATTENDING THE EVENT. I give my consent and permission to The Susan G. Komen Breast Cancer Foundation, Inc. d/b/a Susan G. Komen for the Cure ( Komen ), its affiliates and races, their sponsors and corporate sponsors, their successors, licensees, and assigns the irrevocable right to use, for any purpose whatsoever and without compensation, (i) any photographs, videotapes, audiotapes, or other recordings of me that are made during the course of this event (the Event ); and (ii) the results of my participation in this Event (e.g., race time, name, participant number). I understand that (i) my consent to these provisions is given in consideration for being permitted to participate in this Event; (ii) I may be removed from this competition if I do not follow all the rules of this Event; (iii) I am a voluntary participant in this Event. I am in good physical condition and am solely responsible for my personal health, safety and personal property. I know that this event is a potentially hazardous activity and I hereby voluntarily assume full and complete responsibility for, and the risk of, any injury or accident THAT may occur during my participation in this Event (INCLUDING, BUT NOT LIMITED TO, MY FUNDRAISING ACTIVITIES associated with the event) or while ON THE EVENT PREMISES (COLLECTIVELY, MY PARTICIPATION ). TO THE FULLEST EXTENT OF THE LAW, I, FOR MYSELF, MY NEXT OF KIN, MY HEIRS, ADMINISTRATORS, AND EXECUTORS (COLLECTIVELY, RELEASORS ), HEREBY RELEASE AND HOLD HARMLESS AND COVENANT NOT TO FILE SUIT AGAINST (I) KOMEN, THE ARKANSAS AFFILIATE OF THE SUSAN G. KOMEN BREAST CANCER FOUNDATION D/B/A KOMEN ARKANSAS AFFILIATE, AND ALL OTHER KOMEN AFFILIATES AND THEIR RESPECTIVE DIRECTORS, OFFICERS, VOLUNTEERS, AGENTS AND EMPLOYEES; (II) ANY EVENT SPONSORS; AND (III) ALL OTHER PERSONS OR ENTITIES ASSOCIATED WITH THIS EVENT (COLLECTIVELY, THE RELEASEES ) FOR ANY INJURY OR DAMAGES I MIGHT SUFFER IN CONNECTION WITH MY PARTICIPATION. THIS RELEASE APPLIES TO ANY AND ALL LOSS, LIABILITY, OR CLAIMS I OR MY RELEASORS MAY HAVE ARISING OUT OF MY PARTICIPATION, INCLUDING BUT NOT LIMITED TO, PERSONAL INJURY OR DAMAGE SUFFERED BY ME OR OTHERS, WHETHER SUCH LOSSES, LIABILITIES, OR CLAIMS BE CAUSED BY FALLS, CONTACT WITH AND/OR THE ACTIONS OF OTHER PARTICIPANTS, CONTACT WITH FIXED OR NON-FIXED OBJECTS, CONTACT WITH ANIMALS, CONDITIONS OF THE EVENT PREMISES, NEGLIGENCE OF THE RELEASEES, RISKS NOT KNOWN TO ME OR NOT REASONABLY FORESEEABLE AT THIS TIME, OR OTHERWISE. I UNDERSTAND THAT I AM SOLELY RESPONSIBLE AND LIABLE FOR ALL ASPECTS OF MY FUNDRAISING ACTIVITIES ASSOCIATED WITH MY PARTICIPATION, INCLUDING, BUT NOT LIMITED TO, THE SAFE AND LAWFUL CONDUCT OF ANY FUNDRAISING ACTIVITIES. This Photographic and Results Release and Waiver and Release of Claims (collectively, the Release ) shall be construed under the laws of the state in which the Event is held. In the event any provision of this Release is deemed unenforceable by law, (i) Komen shall have the right to modify such provision to the extent necessary to be deemed enforceable; and (ii) all For the safety of all participants, inline skates and pets are discouraged from participating in this event. Thank you for your cooperation. The 5K Komen Arkansas Race for the Cure is USATF certified and sanctioned # This event will occur rain or shine. We reserve the right to cancel in extreme circumstances. In that event, there will be no refunds, rather, your entry fee will be used as a donation to the Komen Arkansas Race for the Cure. Entry fees are not tax deductible and are not refundable.

5 OFFLINE TEAM REGISTRATION ONLY: 2015 Team Captain s Packing List and Reconciliation Form Please complete this form and include in your team packet. Team Captain: _ Team Name: Company/Organization/Team Affiliation: Shipping Address (No PO Box): City: State: Zip: _ Work Number: (_) Fax: (_) Home Number: (_) CD w/excel spreadsheet enclosed? ed? _ Total Race Entrants (5K & 2K) _ x $25 = $ Competitive Runners 5K _ x $35 = $ (can run 5K in 30 minutes or less. Chip timed.) 5K & 2K Entrants via Complementary Tickets _ x $0 = $ _0.00_ Total Kids for the Cure Entrants _ x $25 = $ Kids for the Cure Entrants via Complementary Tickets _ x $0 = $ _0.00_ Child Under 5 x $0 = $ _0.00_ Total Sleep in for the Cure Entrants _ x $25 = $ Sleep in for the Cure Entrants via Complementary Tickets x $0 = $ _0.00_ Total Three Miles of Men Entrants _ x $25 = $ Three Miles of Men Entrants via Complementary _ x $0 = $ _0.00_ Total # of Pasta Party Tickets _ x $25 = $ Total # of Pink Postcard Tributes (enclose forms) _ x $5 = $ Total $ s collected for Fundraising Program (enclose forms) Total Additional Donations Total Susan G. Komen Foundation Memberships $ $ Annual Memberships _ x $35/yr = $ Patron Memberships _ x $100 = $ Lifetime Memberships _ x $1000 = $ Total Enclosed for all Team Member Registration (Sizes as available) Total Race T-shirts Needed: S M L XL XXL XXXL Total Three Miles of Men T-shirts Needed: _ S _ M L _ XL XXL _ XXXL _ Total Kids for the Cure T-shirts Needed: S M L Mail Race Forms and Fees to: Arkansas Race for the Cure 904 Autumn Road, Suite 500 $ _ *Any dollar amount over the required registration, ticket or membership fees will be credited toward your team total for funds raised

6 RACE PARTICIPANT OPTIONS: 1) Runners/Walkers Competitive Runners Entry Fee: $35 offline/$36 online 5K Run/Walk Entry Fee: $25 offline/$26 online Family 2K Fun Walk/Run Entry Fee: $25 offline/$26 online Each participant receives a race t-shirt¹ and bib. Each Competitive Runner also receives a timing chip.² Survivors also receive a complimentary pink cap and pink survivor t-shirt. On Race Day, registration for Runners/Walkers will increase $5. 2) Three Miles of Men Entry Fee: $25 offline/$26 online Men show your support for the Race by lining the race course and cheering the race participants on! Each participant will receive a Three Miles of Men t-shirt³ and an invitation to the 3MOM Tailgate Party, Thursday, October 1, 2015 at Diamond Bear Brewing Company in North Little Rock. Men may also register at the 3MOM tailgate party. 3) Sleep in for the Cure Entry Fee: $25 offline/$26 online You don t have to be there! This option allows a supporter to participate without being present on Race Day. Each participant receives a race t-shirt³ and bib (just in case you change your mind). 4) Kids for the Cure Event Entry Fee: $25 offline/$26 online Kids, ages 5-12, receive a special t-shirt*, available in youth sizes small, medium and large. On a first come, first serve basis. The Kids for the Cure special area on Race Day will be announced at a later date. More details to follow on under the Race Information tab. 5) Child Under 5 Entry Fee: $0 No fee for children under 5. Participants do not receive a t-shirt, only a Race bib to be worn on Race Day. 6) Donate to a Participant or a Team Even if you cannot participate in the Race, you may donate or sponsor a participant or team. You may donate online at or mail donations to: Komen Arkansas Race for the Cure 904 Autumn Rd. Ste. 500 Donations can be any amount and should be pledged to an individual participant or team. Donations are tax-deductible and will not include a race t-shirt. Fundraising deadline is November 13, ) Race t-shirts are limited. Sorry, all sizes may not be available. 2) Only 1,500 3MOM t-shirts are available. REGISTER EARLY.. 3) T-shirts limited to the first 1,000 registrants. Sorry, all sizes may not be available. No size substitutions.