RARE Community Partners

Name

First Last

Please tell us, are you a...*

Patient
Parent/Family Member
Rare Disease Advocate
Other

Rare Disease or Condition*

Age of RARE Community Partner*

Address*

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

Email*

Phone*

T-Shirt Size*

How did you hear about Running for Rare?*

If other, please describe.

What are your preferred methods of communication?*

RARE Community Partners and their runners will be matched based on their preferences to ensure the best experience for both parties!

Preferences for Your Running Partner*

(E.G. Male or Female, Single or Family/Kids, English Speaking and/or Spanish/Other, etc.)

Runner Location: Do You Have a Preference?*

What 3 words would you choose to describe your personality?*

Please tell us why you are interested in joining our team?*

Please provide at least three full sentences to respond to this question.

Have you advocated for rare diseases in the past? If not, are you interested in becoming an active advocate?

Please provide at least three full sentences to respond to this question.

If you already knew me, you would know that ____________.

Fill in the blank to tell us a little more about yourself.

Would you be interested in sharing your experience being a RARE Community Partner on our blog?*

Yes
No

Visit http://running4rare.org/ for an idea of the types of blogs that we would be interested in asking you to write for the team.

I grant R4R the right to take my personal photo to include but not limited to posting on NORD's website and social media accounts and including it in promotional materials*

Yes
No

Alone we are rare. Together we are strong.®