Blindfold Challenge

SIGN UP FOR THE BLINDFOLD CHALLENGE

Thank you for your interest in the Blindfold Challenge at the B.A.A. 5K on April 16, 2016.

  • The B.A.A. entry fee is $55.00. We will contact you with specific information about how to complete your registration with the B.A.A.
  • The fundraising minimum is $1,000.00, though we encourage you to raise as much as possible. While some of our runners fundraise independently, we encourage runners and guides to work together to hit their fundraising goal!
  • Guides do not have to fundraise, but if they choose to, their funds can be applied to their runner's total.
  • The minimum age for the B.A.A. 5K is 10 years old on race day. Full rules are available on the B.A.A. website.
  • If you need a guide we can match you with one.

FUNDRAISING REQUIREMENTS

Blindfold Challenge participants must meet the fundraising commitment of at least $1,000.00 by May 18, 2016. You have the option to charge any or all of this amount to your credit card. The Blindfold Challenge raises funds for education, literacy and rehabilitation services that help blind and visually impaired individuals live full lives in the community. Your fundraising efforts are greatly appreciated. We will contact you with instructions for setting up your fundraising page.

My fundraising goal is (*)
Fundraising goal is required.

Please allocate the funds that I raise to (*)




Please select your fund allocation.

Last Name (*)
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First Name (*)
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Middle Initial
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Address (*)
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City (*)
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State (*)
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Zip (*)
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Country of Residence (*)
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Citizenship (*)
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Gender (*)
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Cell Phone (*)
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Evening Phone
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Email (*)
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T-Shirt Size (*)
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  Guide T-Shirt Size (*)
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Date of Birth (*)
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MM/DD/YYYY. Must be 10 years of age or older.
Age on 4/16/16 (*)
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Estimated Finish Time (Net) (*)
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Do you have your own guide? (*)
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Guide Name
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Guide Phone Number
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Guide Email
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Number of Previous BAA 5K’s completed
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Are there special reasons for participating in the Blindfold Challenge?
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Short Bio (please include any information that you would like to share about yourself- fun facts, children’s names/ages, how/why you started running)
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Emergency Contact Name 1 (*)
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Relationship (*)
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Cell Phone (*)
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Emergency Contact Name 2
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Relationship
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Cell Phone
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PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING

Waiver: I agree to assume all risk and responsibility of damage or injury that may occur to me as a participant in this event. In consideration of your accepting this entry, I here-by for myself, my heirs, assigns, executors and administrators, release and discharge any and all sponsors including, but not limited to, the Boston Athletic Association, MAB Community Services, Inc. (Massachusetts Association for the Blind and Visually Impaired), National Braille Press, Perkins School for the Blind, the Blindfold Challenge, and the Commonwealth of Massachusetts and all cities or towns in which the race is contested, their representatives, successors and assigns for any and all injuries suffered by me, including death, in said event. I further attest and certify that I am physically fit and have sufficiently trained for the distance I am running. I also grant permission for my name/photo to be used in any broadcast or print media, or any other review of this event. Runners will comply with terms and conditions set by the Boston Athletic Association including, but not restricted to the following: they will not begin the race prior to the official start time; they will not compete in a manner which, in the judgment of race officials, interferes with race operations or other participants; they will not reproduce or transfer their bib number or number card provided by the Boston Athletic Association; any conflicts will result in disqualification of the runner, and review of the organization's standing for participation in future charity programs.

Accountability: This event plays a significant role in our ability to serve individuals who are blind or visually impaired throughout Massachusetts and the country, and each entry represents funds critical to our work. Once you have been registered for this race, your entry cannot be transferred to other runners or reproduced. Injury or other circumstances that might preclude you from participation in or completion of the 2016 B.A.A. 5K does not waive your $1,000.00 fundraising commitment. Therefore, in consideration of accepting an invitational entry, you agree to collect and/or donate a minimum of $1,000.00 by May 16, 2016, and will be held responsible for the entire amount. All funds collected through donations, sponsorships, matching gifts programs or through your own donations, will be allocated to MAB Community Services (Massachusetts Association for the Blind and Visually Impaired), National Braille Press, and Perkins School for the Blind as indicated by you on this form.

I have read and understand the foregoing liability waiver and fund raising agreement
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Please type your initials
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Type What You See (*)
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Contact Us

  • (617) 732-0279

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