Torch Run Relay Form

All runners must wear current year’s Torch Run t-shirts for your relay.

If you have a photographer for your relay, please forward all pictures to Leslie Moyar.

Who is submitting this form?(Required)

First Last

Contact Person(Required)

First Last

County(Required)

Agency hosting relay(Required)

Are there additional agencies participating in the run?(Required)

If yes, please list the additional agencies below.

Yes

No

Additional agency #1 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #1

Additional agency #2 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #2

Additional agency #3 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #3

Additional agency #4 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #4

Additional agency #5 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #5

Additional agency #6 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #6

Additional agency #7 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #7

Additional agency #8 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #8

Additional agency #9 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #9

Additional agency #10 - Include agency name, coordinator name and email address

Please list one agency per line.

Phone number of additional agency #10

RELAY INFORMATION

In which Torch Run leg are you participating?(Required)

Relay date:(Required)

Reporting time:(Required)

:

Start time:(Required)

:

Approximate end time:(Required)

:

Total miles:(Required)

We will receive the torch from:(Required)

We will pass along the torch to:(Required)

Your relay’s starting location address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your relay’s ending location address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parking information:(Required)

Will support transportation be provided from end location back to start location?(Required)

Yes

No

Route (Street name by street name):(Required)

Additional Information

Do you have a torch or banner for your relay? Please check if you would like SONC to send you a banner or a torch for your relay.(Required)

Please provide a banner

Please provide a torch

We will receive a torch from another agency

We have our own torch

Date banner/torch is needed by:

Have you reached out to your local media contact and is your PIO informed of your Relay?

Shipping address to send banner/torch:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date Returning:

A UPS return label will be made for this date to return items. *Please be sure torch bag is zipped CLOSED. Roll banners, DO NOT FOLD for shipping.*

Will your agency join us for the Final Leg at 10 a.m. on Friday, June 3?(Required)

Yes

No

If yes, please provide an email to send invitation to:

Will your agency attend and be represented at the Special Olympics NC Summer Games Opening Ceremony and Circle of Honor on the evening of Friday, June 3?(Required)

Yes

No

If yes, please provide an email to send invitation to:

If you have any questions about the form, contact the NC LETR at (919) 719-7662.