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Captain Request - Niles/Buchanan Thanksgiving Day Run 5K
November 28, 2019
Current Captain Application? *
I have filled out the Captain Application on the Michigan Chapter website at: https://www.myteamtriumph-mi.org/become-a-captain
Last Name *
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First Name *
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Street Address *
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City *
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State *
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Zip *
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Phone *
xxx-yyy-zzzz
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Email *
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Emergency Contact Name *
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Emergency Contact Phone *
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Birthdate *
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Shirt Size *
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Teammate Request
If you would like to team with specific Angels for this event, please share their names here (while we cannot guarantee teaming arrangements, we will do our best to honor your request):
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Event Waiver *
I hereby, for myself, heirs and executors, waive, release, discharge and agree to hold harmless, the Niles-Buchanan YMCA, Chemical Bank, and the other sponsors/contributors of the Thanksgiving Day Run, individually and collectively, together with their successors, assigns, officers, agents, and employees, free and harmless from any and all liability for injuries to property or person suffered by me, and or my heirs, and or executors, in connection with my participation in this event. I verify that I am physically fit and have sufficiently trained for the competitive and physical rigors of the Thanksgiving Day Run.
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