Gabrielle's Angel Foundation TD Five Boro Bike Tour 2019 Application
Thank you for your interest in supporting Gabrielle's Angel Foundation for Cancer Research through participation in the TD Five Boro Bike Tour in 2019! Your involvement will help us to fund our mission to encourage the development of more effective therapies for patients with leukemia, lymphoma and related cancers.

Please fill out the form below in order to express your interest in our 2019 team (please note: spots are not confirmed until we receive approval from Bike NY. Spots are limited and will be filled on a first-come, first-served basis).

A $750 minimum fundraising commitment is required to participate as a rider with Gabrielle's Angel Foundation and receive a Charity Entry for the 2019 TD 5 Boro Bike Tour on May 6, 2018. The Charity package includes VIP charity entry, breakfast and lunch as well as priority start in the first wave of riders, special bike parking at the start, fundraising tips and support up to and during the race, and exclusive Team Gabrielle's Angels race gear.

For questions, contact Michele Keene, Associate Director of Development, at mkeene@gabriellesangels.org or 646-861-2033.

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Street Address, City/State/Zip *
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Have you ridden in the Bike Tour before? *
How did you hear about Gabrielle's Angel Foundation? *
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Terms and Conditions
Please carefully read the terms and conditions below for cyclists who wish to express interest in a guaranteed Gabrielle's Angel Foundation NYC Bike Team entry into the 2019 TD 5 Boro Bike Tour:

A. BIKERS WHO WISH TO SECURE A CHARITY GUARANTEED ENTRY FUNDRAISING COMMITMENT: A $750 minimum fundraising commitment is required to participate as a rider with Gabrielle's Angel Foundation and receive a Charity Entry for the 2019 TD 5 Boro Bike Tour. The Charity package includes breakfast and lunch as well as priority start in the first wave of riders, special bike parking at the start, fundraising tips and support up to and during the race, and exclusive Team Gabrielle's Angels race gear. If you are accepted onto the team, a non-refundable deposit of $50 will be charged to your credit card which will go towards your $750 fundraising commitment. Your deposit reserves a 2019 TD 5 Boro Bike Tour Charity invitational entry in your name.

CANCELLATION POLICY: You may cancel your participation with the Gabrielle's Angel Foundation Bike Team for the 2019
TD 5 Boro Bike Tour, waiving your responsibility for the $750 minimum, any time up to two months before the event date.
You must contact the Gabrielle's Angel Foundation office, in writing, on or before the cancellation date. Your $50
deposit is non-refundable. Donations raised and received by our office will not be refunded, even if you cancel before the deadline. After the deadline, you are responsible for raising the $750 minimum, even if for any reason, including injury, you are unable to participate.

MATCHING GIFT POLICY: Many companies match employees' charitable contributions. You can check with your
employer to see if your company has this program, and ask your donors if their employers match gifts. Many companies
issue matching gift checks quarterly or semi-annually, therefore, it is your responsibility to contact the matching company
to determine when the check will arrive. As long as we have written confirmation from the company that they are in receipt of the request, we will soft credit your fundraising account.

2019 TD 5 BORO BIKE TOUR REGISTRATION: Entries will be made available through a special online
registration system developed and administered by Bike New York. When you register as a member of the Gabrielle's Angels Bike Team there will be no additional TD 5 Boro Bike Tour Processing or Entry Fees. Registration packets can be
picked up free of charge at the Bike New York Expo. *Please do not sign up/pay for an entry via the general Bike NY website - this will not qualify you for the VIP charity perks. You must follow the personalized link that will be provided to you by Gabrielle's Angel Foundation*

RELEASE FORM AND CONTRIBUTION AGREEMENT:
In consideration of my accepting this entry, I hereby for myself, my heirs, executors and administrators, waive and release
any and all rights and claims for damages I may have against Gabrielle's Angel Foundation for Cancer Research and sponsors for any and all injuries suffered by me in said event. I further attest and certify that I am physically fit and have sufficiently trained for this event, and a licensed medical doctor has verified my physical condition. I also grant permission for use of my name and/or photograph or voice in broadcast, telecast, print or any other account of this event. I agree to collect the fundraising minimum ($750 for riders who receive a Charity Guaranteed Entry from Gabrielle's Angel Foundation) for Gabrielle's Angel Foundation by the event date. If I have not reached the minimum in fundraising by that date, I will be required to continue fundraising beyond the event or be personally responsible for the balance owed. I understand that unless I cancel two months before the event, Gabrielle's Angel Foundation reserves the right to hold me accountable for my $750 fundraising commitment.

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A copy of your responses will be emailed to the address you provided.
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