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

School Name*

2.Please write teachers names, grade they are teaching and number of students in each class:

Teachers names, grade they are teaching, and number of students*

For example – Ms. Smith, Grade 2, 30 Students. Mr. Peterson, Grade 6, 20 Students.

3. How many adults will accompany the students?

Number of adults*

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

10:45 am - 11:30 am *

1:30 pm - 2:15 pm*

5. 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*

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

Questions/feedback

7. 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*