Text Size

A A A

Search


 

Stroke Challenge - Challenge Yourself. Challenge Stroke.

2014 TCS New York City Marathon

 

 Thank you for your interest in our TCS New York City Marathon Stroke Challenge team!

Please provide the following information:

1. Contact Information

*

Name:

 

 

   

*

*

 

*

City/State/ZIP:

 

    

*

*

*

 


2.
Question - Not Required - Birth date (if you are under the age of 18, birth date is required).




*3.
Question - Required - I would like to request a space on National Stroke Association's 2014 TCS New York City Marathon. I commit to raise a minimum of $3,000 for National Stroke Association by December 31, 2014. If selected I will receive guaranteed race entry from National Stroke Association. I understand that I am responsible for completing the fundraising requirement of $3,000 no later than December 31, 2014, and if this minimum is not met by that date my credit card will be charged for the remaining balance due.

*4.

(Maximum response 255 chars, approx. 5 rows of text)

*5.

(Maximum response 255 chars, approx. 5 rows of text)

6.

(Maximum response 255 chars, approx. 5 rows of text)

   Please leave this field empty