1. Please provide the name of the School confirming its attendance:

School Name*

2. Please indicate the number of each students in which grade(s) will be participating:

Use '0' if no students from that grade will be participating

Kindergarten*

Grade 1*

Grade 2*

Grade 3*

Grade 4*

Grade 5*

Grade 6*

Grade 7*

3. How many teachers/parents will be accompany the students?

Number of teachers/parents:*

4. Please provide your school day times

Please note if you have early dismissal

School day start time*

Recess start time*

Recess end time*

Lunch start time*

Lunch end time*

School day end time*

5. Please state your 1st, 2nd and 3rd choice from the following run times:

9:30 am - 10:15 am*

10:45 am - 11:30 am *

1:30 pm - 2:15 pm*

6. How long will it take your students to travel to the PNE and how will they travel?

e.g. 30mins walking or 10mins bus *

7. Please provide the following contact information for your designated liaison with the PNE:

Full Name*

Position at school *

Contact phone number*

Please provide a cell number if possible, to allow for contact on the day of the run

Contact email address*

8. Do you have any questions or feedback for the Terry Fox Run hosted by the PNE?

Questions/feedback

9. I UNDERSTAND THAT

Please read and tick below to confirm

a. This is a partnership event between the PNE and local schools. The PNE's role is to provide secured routes for students to use; refreshments; and first-aid staff.

b. Schools are responsible for transporting students to and from the event, including working out the best way to transport students (i.e. best walking route/gate to enter); getting waivers filled out for each students; and providing event information to students, staff & parents before the event.

c. The PNE will confirm the time that the school will be invited on-site for the event and event details in the first week of September 2023.

d. The liaison for the school is required to review the event details and email comments/concerns to the PNE.

I understand*