Your information
Required fields are marked with an asterisk (*)
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Mobile Phone Number *
A full 10-digit phone number (for example: 555-123-1234, (555) 123-1234, 555.123.1234, etc)
Birthdate *
A valid date as MM/DD/YYYY (for example: 12/04/1989)
Sex *
T-Shirt Size *
Emergency Contact Name *
Emergency Contact Number *
Medical Certification Status (Enter "N/A" if this isn't applicable to you) *
If Other, please specify
State of Medical License (if not licensed, please choose N/A) *
Medical License Number (Enter N/A is this isn't applicable to you) *
Medical License Expiration Date (Month/Day/Year) (Enter N/A is this isn't applicable to you) *
Upload a copy of your Medical License (If applicable)
Have you ever volunteered for the Turkey Trot?
If Yes, how many times?
Comments
What is your radio "Call Sign"
Please upload a photo of yourself to use on a Volunteer ID Badge. (Recommended not required)
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. §5041; MCO P1700.27B; Marine Corps Marathon Charter, 27 March 2007.
PURPOSE: Information is collected to register, acknowledge, and promote participation in Marine Corps Marathon race events. The Marine Corps Marathon Office and its sponsors use information to plan, organize, coordinate, and execute events, including comm
ROUTINE USES: Any release of information contained in this system of records outside of DoD will be compatible with the purposes for which the information is collected and maintained. The DoD Blanket Routine uses may apply to this system of records.
DISCLOSURE: Providing information is voluntary; however, failure to complete the form will limit the Marine Corps Marathon organizations ability to register runners and volunteers and to communicate with organizations or individuals outside of DoD and
may adversely impact individuals from participation in Marine Corps Marathon events.
Disclaimer
MARINE CORPS MARATHON PUBLICITY RELEASE
I hereby grant permission to the Marine Corps Marathon and its sponsors to use all information submitted in my application, and any photograph, videotape, motion pictures, recording and any other record of this event including race results, my likeness, name and completion time for any lawful purpose related to the race and post-race publicity. The United States Government has requested that I grant, release, and discharge certain rights arising from my appearance, or the appearance of an infant or minor child for whom I execute custody, in any picture, video, advertisement, or other recording or presentation as a result of my participation in the Marine Corps Marathon (MCM), Marine Corps Historic Half, MCM Event Series and other related events. I hereby grant and release to the United States Government the right to use my name, likeness, and personal information, or that of said infant or minor child, in any manner, and to photograph, videotape, make motion pictures, recordings or any other record of; to reproduce, duplicate, publish, exhibit, use or transmit the same or any parts thereof, by any means, in any manner and for any purpose whatsoever; and to do the same perpetually. This voluntary grant and release will not be made the basis of a future claim of any kind against the United States Government. I release and discharge the United States Government from any cause of action arising from my participation or the participation of the infant or minor child in the production. This grant, release, and discharge shall inure to the benefit of the United States Government, and its officers, agents, servants, and employees when acting in their official capacities; and to persons, firms or corporations contracting with the United States Government and state and local government entities supporting these events, and their heirs, executors, administrators, successors, or assigns; and to any other persons lawfully reproducing, distributing, exhibiting, or otherwise using the said production or any portion thereof. OMB NO.: 0703-0053
AGENCY DISCLOSURE STATEMENT
The public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 (OMB#0703-0053). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a current valid OMB control number.
Volunteer Agreement, DD Form 2793, May 2009
Installation: Marine Corps Base Quantico
Program: Marine Corps Marathon
I expressly agree that my services are being provided as a volunteer and that I will not be an employee of the United States Government or any instrumentality thereof, except for certain purposes relating to compensation for injuries occurring during the performance of approved volunteer services and liability for tort claims as specified in 10 U.S.C. Section 1588(d)(2). I expressly agree that I am neither entitled to nor expect any present or future salary, wages, or other benefits for these voluntary services. I agree to be bound by the laws and regulations applicable to voluntary service providers, and agree to participate in any training required by the installation or unit in order for me to perform the voluntary services that I an offering. I agree to follow all rules and procedures of the installation or unit that apply to the voluntary services that I am offering.
MARINE CORPS MARATHON PUBLICITY RELEASE
I hereby grant permission to the Marine Corps Marathon and its sponsors to use all information submitted in my application, and any photograph, videotape, motion pictures, recording and any other record of this event including race results, my likeness, name and completion time for any lawful purpose related to the race and post-race publicity. The United States Government has requested that I grant, release, and discharge certain rights arising from my appearance, or the appearance of an infant or minor child for whom I execute custody, in any picture, video, advertisement, or other recording or presentation as a result of my participation in the Marine Corps Marathon (MCM), Marine Corps Historic Half, MCM Event Series and other related events. I hereby grant and release to the United States Government the right to use my name, likeness, and personal information, or that of said infant or minor child, in any manner, and to photograph, videotape, make motion pictures, recordings or any other record of; to reproduce, duplicate, publish, exhibit, use or transmit the same or any parts thereof, by any means, in any manner and for any purpose whatsoever; and to do the same perpetually. This voluntary grant and release will not be made the basis of a future claim of any kind against the United States Government. I release and discharge the United States Government from any cause of action arising from my participation or the participation of the infant or minor child in the production. This grant, release, and discharge shall inure to the benefit of the United States Government, and its officers, agents, servants, and employees when acting in their official capacities; and to persons, firms or corporations contracting with the United States Government and state and local government entities supporting these events, and their heirs, executors, administrators, successors, or assigns; and to any other persons lawfully reproducing, distributing, exhibiting, or otherwise using the said production or any portion thereof. OMB NO.: 0703-0053
AGENCY DISCLOSURE STATEMENT
The public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 (OMB#0703-0053). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a current valid OMB control number.
Volunteer Agreement, DD Form 2793, May 2009
Installation: Marine Corps Base Quantico
Program: Marine Corps Marathon
I expressly agree that my services are being provided as a volunteer and that I will not be an employee of the United States Government or any instrumentality thereof, except for certain purposes relating to compensation for injuries occurring during the performance of approved volunteer services and liability for tort claims as specified in 10 U.S.C. Section 1588(d)(2). I expressly agree that I am neither entitled to nor expect any present or future salary, wages, or other benefits for these voluntary services. I agree to be bound by the laws and regulations applicable to voluntary service providers, and agree to participate in any training required by the installation or unit in order for me to perform the voluntary services that I an offering. I agree to follow all rules and procedures of the installation or unit that apply to the voluntary services that I am offering.
Check here to show you accept the terms stated above for yourself or for a minor Volunteer for which you are the parental guardian.