entry form whether you walk, run or stroll, you always win ... community... · 1201 east garrison...

2
April 14th, 2018 9:00 a.m. 1201 East Garrison Blvd. Gastonia, North Carolina 28054 P.O. Box 123 Gastonia, North Carolina 28053 PH: (704) 864-0927 FX: (704) 869-0222 www.cfgaston.org Non-Profit Org. U.S. Postage PAID Charlotte, NC Permit # 3609 Whether you walk, run or stroll, you always win with the If you wish to donate to the 2018 Run, please complete Donor Form. ENTRY GUIDELINES Complete Entry Form and sign waiver at bottom. Mail (PO Box 123, Gastonia, NC 28053) or deliver (1201 E. Garrison Blvd., Gastonia, NC 28054) to the Community Foundation with registration fee. Baby joggers, strollers, participants in wheelchairs, and dogs are welcome. All participant registration fees include t-shirt. T-shirts available for sale on Run Day at the donations and information booth, while supplies last. REGISTRATION & PACKET PICKUP Packet pickup for preregistered runners will be available April 9-13 from 9:30am-4:30pm at the Foundation. Race day registration and packet pickup will be availble on April 14 from 6:30am-8am at the Rotary Pavilion. AWARD CATEGORIES 5K participants have a chance to win prize money for a participating non-profit of their choice in the following categories: Overall Male/Female Winner (not eligible for age group awards) 1st and 2nd place Male/Female Winner in the following age categories: 9 and under 10 – 14 15 – 19 20 – 24 25 – 29 30 – 34 35 – 39 40 – 44 45 – 49 50 – 54 55 – 59 60 – 64 65 – 69 70 and up (Please print; one form per person) Check one: o 5K Run o 2K Walk Name: Address: City: State: Zip: Phone: Date of Birth: Email: o I forgo a t-shirt in lieu of a donation to the Match Fund. Male o Female o T-shirt Size: Adult S M L XL XXL Participating Nonprofit Team:________________________ ENTRY FEES Pre-registration is encouraged to participate in the 5K Run and 2K Walk. CASH NOT ACCEPTED. 5K Run - $25 (until March 31) $30 (April 1 - April 13) $35 (on Run Day) 2K Walk - $10 (until March 31) $15 (April 1 - April 13) $20 (on Run Day) Online 5K Registration before March 31 is $20. Register online and SAVE at www.cfgaston.org RACE WAIVER You must sign this waiver of liability prior to entering into the 2018 Run. All minors must be accompanied by an adult. I hereby release sponsors and organizers of 2018 Community Foundation Run from any claims for damages or injuries suffered by me and waive any claim that I might have against the sponsors and organizers for damages arising out of, or in any way relating to, my participating in this event. I give permission to the event organizers, without limitation or obligation, to use and publish photographs or videos of me from the event for promotion purposes and release the Community Foundation of Gaston County from any claim of liability to that use If entrant is a minor: I, _________________________the legal guardian or parent of hereby consents to permit and accept responsibility for emergency medical treatment in the event of injury or illness. X Date Signature of Participant (even if a minor) X Date Signature of Legal Guardian or Parent ENTRY FORM

Upload: hoangliem

Post on 03-Apr-2018

215 views

Category:

Documents


2 download

TRANSCRIPT

April 14th, 2018

9:00 a.m.

1201

Eas

t Gar

rison

Blv

d.G

asto

nia,

Nor

th C

arol

ina

2805

4

P.O. B

ox 1

23G

asto

nia,

Nor

th C

arol

ina

2805

3

PH:

(704

) 864

-092

7FX

: (7

04) 8

69-0

222

ww

w.c

fgas

ton.

org

Non

-Pro

fit O

rg.

U.S

. Pos

tage

PAID

Char

lott

e, N

CPe

rmit

# 36

09 Whether you walk, run or stroll,

you always win with the

If you wish to donate to the 2018 Run, please complete Donor Form.

ENTRY GUIDELINES• Complete Entry Form and sign waiver at

bottom. Mail (PO Box 123, Gastonia, NC 28053) or deliver (1201 E. Garrison Blvd., Gastonia, NC 28054) to the Community Foundation with registration fee.

• Baby joggers, strollers, participants in wheelchairs, and dogs are welcome.

• All participant registration fees include t-shirt.

• T-shirts available for sale on Run Day at the donations and information booth, while supplies last.

REGISTRATION & PACKET PICKUP• Packet pickup for preregistered runners will

be available April 9-13 from 9:30am-4:30pm at the Foundation.

• Race day registration and packet pickup will be availble on April 14 from 6:30am-8am at the Rotary Pavilion.

AWARD CATEGORIES5K participants have a chance to win prize money for a participating non-profit of their choice in the following categories:• Overall Male/Female Winner

(not eligible for age group awards)• 1st and 2nd place Male/Female Winner in the

following age categories:9 and under

10 – 1415 – 1920 – 2425 – 29

30 – 3435 – 3940 – 4445 – 4950 – 54

55 – 5960 – 6465 – 69

70 and up

(Please print; one form per person)

Check one: o 5K Run o 2K Walk

Name:

Address:

City: State: Zip:

Phone: Date of Birth:

Email:

o I forgo a t-shirt in lieu of a donation to the Match Fund.Male o Female o T-shirt Size: Adult S M L XL XXL

Participating Nonprofit Team:________________________

ENTRY FEESPre-registration is encouraged to participate in the 5K Run and 2K Walk. CASH NOT ACCEPTED.

5K Run - $25 (until March 31) $30 (April 1 - April 13) $35 (on Run Day)

2K Walk - $10 (until March 31) $15 (April 1 - April 13) $20 (on Run Day) Online 5K Registration before March 31 is $20. Register online and SAVE at www.cfgaston.org RACE WAIVERYou must sign this waiver of liability prior to entering into the 2018 Run. All minors must be accompanied by an adult.

I hereby release sponsors and organizers of 2018 Community Foundation Run from any claims for damages or injuries suffered by me and waive any claim that I might have against the sponsors and organizers for damages arising out of, or in any way relating to, my participating in this event. I give permission to the event organizers, without limitation or obligation, to use and publish photographs or videos of me from the event for promotion purposes and release the Community Foundation of Gaston County from any claim of liability to that use

If entrant is a minor:I, _________________________the legal guardian or parent of

hereby consents to permit and accept responsibility for emergency medical treatment in the event of injury or illness.

X DateSignature of Participant (even if a minor)

X DateSignature of Legal Guardian or Parent

ENTRY FORM

AIDS Council of Gaston CountyAlfred C. Kessell History Center at Loray

MillAlliance for Children & Youth/

Communities In SchoolsAmerican Legion Post 23American Red CrossAnimal League of Gaston CountyThe Arc of Gaston CountyAshbrook Foundation, Inc.Ashbrook High SchoolB.R.E.A.D., Inc.BackPack Weekend Food Program, Inc.Belmont Abbey CollegeBelmont Community OrganizationBelmont Historical SocietyBelmont Rowing CenterBessemer City Crisis CenterBit of Hope RanchBoys & Girls Clubs of Greater GastonThe Brice FoundationCamp Sertoma of Gaston CountyCamp SunshineCancer Services of Gaston CountyCarolina Express Track and FieldCarolina Pro MusicaCatawba Lands ConservancyCatherine’s HouseThe Cathy Mabry Cloninger Center - A

Domestic Violence ShelterCherryville Area Ministries & Thrift ShopChrist Community Baptist Church -

Outreach Food Ministry

Classroom Central, Inc.Cornerstone Christian CenterCovenant Community PreschoolCramerton Middle SchoolCrime Stoppers of Gaston CountyCrisis Assistance Ministry (CAM)Crisis Pregnancy Center of Gaston

County, Inc.Dallas High Shoals Christian MinistryDaniel Stowe Botanical GardenDream Center of Gaston CountyElements of Empowerment, Inc.eSTEAM ClubFamily Promise of Gaston CountyFirst Presbyterian Weekday School -

BelmontFlynn Fellowship Home of GastoniaForestview High SchoolFriends of the Gaston County Public

LibraryGaston AquaticsGaston Arts CouncilGaston Choral SocietyGaston Christian SchoolGaston College FoundationGaston Community Action, Inc.Gaston Concert AssociationGaston County Art GuildGaston County Education FoundationGaston County Extension & Community

AssociationGaston County Family YMCA

Gaston County Fellowship of Christian Athletes

Gaston County Museum of Art & HistoryGaston County Parks and Recreation

Park PartnersGaston County Young LifeGaston Dance TheatreGaston Day SchoolGaston County DHHSGaston Family Health ServicesGaston GatorsGaston HospiceGaston Humane Society Inc.Gaston Literacy Council, Inc.Gaston Music Education FoundationGastonia Potters HouseGaston Residential Services Inc.Gaston School of the ArtsGaston Skills, Inc.Gaston String OrchestraGaston Symphonic BandGaston TogetherGaston United Soccer ClubGastonia Parish Nurse MinistryGastonia Sister CitiesGirl Scouts Carolinas Peaks to PiedmontGirls on the Run Gaston CountyHabitat for Humanity of Gaston CountyHealthNet GastonHeart Society of Gaston County, Inc.High Caliber Athletics Inc.Highland School of Technology PTSOHoly Angels, Inc.

Hoyle Historic HomesteadJack and Jill of America Gastonia-

Piedmont ChapterJunior Achievement of Central CarolinasJunior League of Gaston CountyKeep Belmont BeautifulKeep Gastonia BeautifulLeast of These CarolinasLet Me Run Gaston CountyThe Lighthouse-Children’s Advocacy

CenterLittle Theater of GastoniaLoray Girls’ Home, Inc.Lowell Women’s ClubMayor’s Youth Leadership CouncilMended Hearts of GastoniaMiraViaMount Holly Community Development

FoundationMount Holly Community Impact FundMount Holly Farmers MarketMount Holly Historical Society, Inc.Mt. Holly Community Garden, Inc.Mt. Holly CRONext Generation FundNoon Optimist Club of GastoniaNCCATT FoundationOff the Streets Program, Inc.Partnership for Children of Lincoln and

Gaston CountiesPaul Fuller Scholarship for Mentored

StudentsPerry Fewell Leadership Scholarship

PFLAG GastonPhoenix Community & Outreach CenterPiedmont Council, Boy Scouts of

AmericaPlace of Refuge of Gaston County,IncPresbyterian Weekday SchoolPrevent Child Abuse Gaston, Inc.Robinson Elementary SchoolRotary Community Garden of GastoniaS.O.C.K.S. Crisis MinistrySafe Kids GastonThe Salvation ArmyThe Schiele Museum of Natural HistorySalvation Army Boys & Girls Clubs of

Gaston CountySecond Harvest Food Bank of MetrolinaShining Hope FarmsSmith Cemetery Historic Preservation

Association, Inc.Special Kare MinistriesSpecial Olympics Gaston CountySt Michael Catholic SchoolStable ResourcesTeens Changing Gaston CountyThe Thomas Cricket Smith IV Scholarship

FoundationTri-County Animal RescueUnited Way of Gaston CountyVictory Farm Inc.Voices for Kids, Inc.W.A. Bess Elementary School PTOWebb Street SchoolWith Friends, Inc.

DONOR FORMOnline donations at www.cfgaston.org/donate

Cash NOT accepted

Name:

Address:

City: State: Zip:

Phone:

Email:

2018 RUN CONTRIBUTIONSMy gift to the MATCH FUND, which supports all participating non-profit organizations $

My gift(s) to participating non-profit organizations:

$

$

$

$

$

$

$

$

TOTAL GIFTS FOR 2018 RUN: (Match Fund and Non-profits) $

Donations less than $250 will be acknowledged only upon request.

o I wish this gift to remain anonymous.

o I would like to learn more about the Community Foundation of Gaston County and ways they can assist me with charitable giving.

COMPLETED DONOR FORM: Please mail (PO Box 123, Gastonia, NC 28053) or

deliver (1201 E. Garrison Blvd., Gastonia, NC 28054) to the Community Foundation of Gaston County.

CONTRIBUTION GUIDELINES • Cash is NOT accepted. • All checks payable to the Community Foundation.• For stock transfers, please contact the Foundation.• All gifts must be made before 5:00 pm, Friday,

April 20, 2018.• Gifts CANNOT include membership dues, pledge

payments, fees or event entries.• To receive gifts, organization must be a registered

participant in the 2018 Run. Refer to the list below, our website (www.cfgaston.org), or call charity of your choice to determine qualification.

WANT TO LEARN MORE OR GET INVOLVED? Please contact the Foundation because it’s not just about the money, it’s about bringing our community together!

Community Foundation of Gaston County, Inc.

P.O. Box 123 (28053) 1201 E. Garrison Blvd. (28054)

Gastonia, NC www.cfgaston.org

phone 704-864-0927 fax 704-869-0222

PARTICIPATING NON-PROFITS

2018 COMMUNITY FOUNDATION RUN

The Run is an opportunity to unite donors, community volunteers, and businesses in fun camaraderie to support the good works of non-profits in Gaston County.

Since inception, the Community Foundation Run has raised $18,450,634 for local non-profits and the Community Foundation has granted $3,088,000. There are 146 non-profits participating in the 2018 Run.

ABOUT THE COMMUNITY FOUNDATIONFounded in 1978, the Foundation currently manages more than $90 million in assets and 395 charitable funds. As a leader of philanthropic giving in Gaston County, the Foundation focuses on connecting donors and the needs of our community.

WHEN:

WHERE:

WHAT:

Saturday, April 14, 2018; Race begins at 9AM

Rotary Pavilion, Downtown Gastonia

5K Run, 2K Walk, non-profit booth exhibits, live music, and more!

THE MATCH FUND• What is the Match Fund?

A collective fund of money shared by all participating non-profits.

• Where do match funds come from? The Community Foundation, sponsorships, and individuals like you!

• How is the match percentage calculated? Matching funds available divided by non-profit dollars eligible for match ($10,000 cap per organization).

• How can I contribute? Simply notate your contribution on the Donor Form and include in your total contribution.