Event Registration Form

Walk two mil
es for a child
CH5213
19, 2015
Saturday, Sept.
n at the
8:30 am to Nooe Office
CHFC Corporat
of Christ
Sunset Church
Street
nd
72
SW
1
1200
you!!
ar
ne
n
Or a locatio
Walker’s Name
20th Annual Extra Mile
Walkathon!
Sponsor Pledge Form
Copy this form and invite your friends to
walk too!
Mailing Address
I am walking In Honor of:
______________________________
City, State, Zip, Phone
I am walking In Memory of:
_____________________________
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
T-shirt Size: S
M
L
XL
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Pledge Collected ___________
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Pledge Collected ___________
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Pledge Collected ___________
With every step, you wipe away a tear.
Please bring this form along with your collected pledges with you to the walkathon site the day of the event, OR give your form and
collected pledges to your advisory council member, OR mail your form along with a check for your collected pledges to:
Christian Homes for Children, Inc. 12001 SW 72nd Street, Miami, FL 33183
Your gifts are tax deductible.
Join us for a day of fun and
exercise and help at-risk
children in our community.
call:
formation
in
e
r
o
m
r
7
Fo
5-825-051
Phone: 30 0-1310
4
Fax: 305-7 aol.com
2
m @
Email: snz
Waiver: I certify that I am in good health for
this two-mile walk and I release the
organization from any liability for this event.
Signature
Date
Signature of parent or guardian if under 18 years of age.
Date
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Pledge Collected ___________
Sponsor’s Name
Address
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Sponsor’s Name
Address
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Pledge Collected ___________
Sponsor’s Name
Sponsor’s Name
Address
Address
City, State, Zip
City, State, Zip
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
$10 _____ $15 _____ $25 _____ $50 _____ $100 _____ Other _____
Pledge Collected ___________
Pledge Collected ___________
Praise be to God for those who “contribute in generosity, lead with zeal, and perform acts of mercy with cheerfulness.”
Romans 12:8
20th Annual Extra Mile
5
, 201 he
9
1
y
at t
da
Satur to NoonOffice
rate
am
st
8:30 CHFC Cohrpuorch of Cthreriet
dS
et C
Suns 1 SW 72n ar
1200
n ne
Or a
io
locat
!
yo u!
PRINT WALKER’S NAME
Walkathon!
Walker Sign-Up Sheet
BEST CONTACT NUMBER
Walk two miles for a child!
T-SHIRT SIZE: S M L XL XXL 1X
2X (ONE T-SHIRT PER WALKER PLEASE)
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Proceeds will benefit abused and neglected children
PRINT WALKER’S NAME
BEST CONTACT NUMBER
T-SHIRT SIZE: S M L XL XXL 1X
2X
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Christian Homes for Children, 12001 SW 72nd Street, Miami, FL 33183
For more information call 305-825-0517, FAX: 305-740-1310 or send an e-mail to [email protected]

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