Run For Holland/ Speed For Need Nomination Entry Form
Run For Holland is excited to announce our partnership with Speed For Need. The MISSION of SPEED FOR NEED is to empower members of the community affected by disability or disease through participation in fitness events. Simply put, our goal is to help people get to the Finish Line and FINISH the race… their race.

WE NEED ONE RACING CHAIR FILLED
We have reserved 3 of the 4 chairs pictured below filled with local individuals with disabilities but we are looking for one more.  If you want to nominate someone you know with a disability please email us with their name and contact information. We will be entering those names into a lottery and selecting them on World Down Syndrome Day 2018 (March 21). 

Nominee First Name *
Your answer
Nominee Last Name *
Your answer
Nominee City *
Your answer
Nominee State *
Your answer
Nominee Age *
Your answer
Disability *
Your answer
Brief Statement Why You Are Nominating Them *
Your answer
Name of Person Nominating *
Your answer
Contact Email *
Your answer
Contact Phone Number *
Your answer
I agree that by nominating this person that they would be willing to be pushed at the 2018 Run For Holland (May 5) by a group of runners. *
Required
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