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Angel Request - ORS P.C. Rose Run 5K                              
June 9, 2018
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Current Angel Application? *
I have filled out the Angel Application on the Michigan Chapter website at:  https://www.myteamtriumph-mi.org/become-an-angel
Last Name *
First Name *
Phone *
xxx-yyy-zzzz
Email *
Pace *
This is an 5K run.  Please provide your pace per mile for this distance.  MyTeam Triumph makes an effort to team Angels with others of similar pace.
Angel Team Members
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):  
Captain Team Member
If you would like to team with a specific Captain for this event, please share his or her name here (while we cannot guarantee teaming arrangements, we will do our best to honor your request):  
Event Waiver and Registration *
In an effort to consolidate waiver signatures and registration fee's between myTEAM TRIUMPH and specific event signup pages, the titled event's waiver statement and registration fee paragraph are included here in these last two inputs.  This allows myTEAM TRIUMPH to capture your waiver and entry fee on behalf of this event host, and as a myTEAM TRIUMPH participant.
Required
Event Waiver *
In consideration of [the race host] accepting this entry, I, the participant, intending to be legally bound and hereby waive or release any and all right and claims for damages or injuries that I may have against the Event Director, RunSignup.com, and all of their agents assisting with the event, sponsors and their representatives and employees for any and all injuries to me or my personal property.  This release includes all injuries and/or damages suffered by me before, during or after the event.  I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.  I also authorize the use of photographs or videos that include my image for promotional, informational, or other reasons deemed to be in the best interest of the event.  I certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that my physical condition has been verified by a licensed Medical Doctor.  By submitting this entry, I (or a parent or adult guardian for all children under 18 years) acknowledge having read and agreed to the above waiver.
Required
Event Registration Fee *
As a charity organization, myTEAM TRIUMPH relies on donations from Angels, family, friends, employers, etc.  Your donation here, directed to myTEAM TRIUMPH, takes the place of the common registration fee you pay on the event signup website.  Any additional donation amount here will support our mission of enabling additional individuals with disabilities to participate in endurance athletics.  MyTEAM TRIUMPH will cover total event registration requirements for our participant list via one lump sum payment. The minimum event registration fee will preclude any packet materials provided by event sponsors, including event shirt.  
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