Incentive Application Form

Were you in a Marathon Relay Team (10.55km x 4) ?*
- Yes
- No
Team Name*
Name of the Team Captain*
First Last
Your Name*
First Last
Your Gender*
- Female
- Male
Date of Birth*
MM
DD
YYYY
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address City Province Postal Code
Choose your Marathon*
- Full Marathon (42K)
- Half Marathon (21K)
- 10K Run
- 5K Run (13 or older)
- 5K Run (12 or under)
- 42K+21K+10K+5K
- Double Up 42K +10K
- Double Up 21K +10K
- Double Up 10K +5K
Are you a full-time student?*
- Yes
- No
Please upload a VOID cheque for reimbursement process*
*To ensure that your account information is correct, please attach a cheque marked "VOID". Your incentive payments will be directly deposited to the specific bank account above.

Tel:	+1 (905) 944-1944
Fax:	+1 (905) 944-1950
E-mail:	[email protected]
Address:	232 Hood Road, Markham, Ontario, Canada, L3R 3K8 (map)
Hours:	Monday-Friday: 10:00 AM-6:00 PM