Team Tillman Application

Make your marathon experience more meaningful by running on behalf of the Pat Tillman Foundation!

Running a marathon for a charity not only provides you with guaranteed entry, it also gives you the opportunity to directly support Tillman Scholars. We currently have opportunities available with the New York City and Chicago marathons as part of their charity bib program, but we can discuss how we can support you for other events too.

Participant Information

First Name

Last Name

Address Line 1

Address Line 2

City

State

Postal Code

Phone

Primary Email

Gender

Date of Birth

Emergency Contact Name

Emergency Contact Phone

T-Shirt Size

What event are you applying to participate in?

Bank of America Chicago Marathon (October 2024 | Fundraising Minimum: $1,750.00)TCS New York City Marathon Waitlist (November 2024 | Fundraising Minimum: $3,500.00)Any event you choose (No minimum)

Anticipated Finish Time

Personal Fundraising Goal

How did you hear about Team Tillman?

Tell us about yourself. Why are you running/fundraising for the Pat Tillman Foundation?

What type of assistance or support would you need from the Pat Tillman Foundation to successfully meet your fundraising goal?

In consideration of my acceptance of participation as a member of Team Tillman, I herby for myself, my heirs and administrators waive any and all rights and claims of damages I may have against the Pat Tillman Foundation (PTF) and will hold them harmless for any and all injuries suffered in connection with said participation. Also, PTF is not responsible for the loss of personal items or any other form of aggravation in connection with said event. I have been warned I must be in good health to participate in an athletic event. In filling out this form, I also give permission for free use of my name and likeness in any broadcast and print media accounting of this event.

Submitting this application does not guarantee entry into this event. The Pat Tillman Foundation must approve every registrant and your entry is not guaranteed until you have received confirmation from the team organizer. By accepting a Team Tillman entry, you understand that Charity Guaranteed entries cannot be deferred and you will be responsible for meeting the fundraising minimum within the specified timeframe.

By signing this application, the undersigned agrees that he/she/they has read and agrees to the terms and conditions listed above.

Participant's E-Signature

Date

If you have questions or need additional information please email teamtillman@pattillmanfoundation.org

Contact Information