Team Change Request Form

ACLI Capital Challenge Team Change Request Form

To make a change to your Team Registration, please complete the form below.

Team Name: *

We ask to remove this person from our team: *

Name

or on And

And replace them with: *

Name

Occupation *

Phone: *

Email: *

Print/Web Byline Journalist or Editor?

Electronic On Air?

Sex *

Do you still have at least one woman on the team? *

Predicted 3 Mile Time (Minutes:Seconds): *

Captain or contact: *

Email: *

Day Phone: *

Cell Phone:

Your team change request is subject to review and approval.

We will notify you once approved, or if there are any issues.

The new team member will be required to sign a waiver (if they haven’t already) to be eligible to participate on race day.

If you have any questions or concerns, please contact Whitney Dunn at [email protected] or 202-624-2303