Four steps in support of
Recovery Walks! 2009
1. Walk! Individual walkers unite! Walk for
just $15 per person, and children 12 and
under walk for $10.
2. Families matter! Just $40 per family.
Get up to four t-shirts for you and your
family. Each additional t-shirt is $7.00.
3. Steppers! (team) Call on your family,
friends, and co-workers ... develop your
team. All teams must consist of a maximum
of 20 walkers and raise a minimum of $250.
4. We love donors too! Can’t attend the
Walk - a donation to Recovery Walks! 2009
would be just great. Make checks payable
to: The Proctor Health Care Foundation.
To pay by credit card call: 1-800-522-3784.
To benefit the Ameel Rashid
Scholarship for Addiction Recovery
SaWurday, September 26
10:00 a.m.-2:00 p.m.
Walk at 11:00 a.m.
If you want to be recognized, please identify your
years of recovery on the registration form.
Illinois Institute for Addiction
Recovery at Proctor Hospital
5409 N. Knoxville Ave., Peoria
5409 N. Knoxville Ave.
Peoria, IL 61614
The Honor Guard consists of people who consider
themselves in recovery, and will be recognized as
living proof of sustained recovery. We will celebrate
recovery by recognizing an individual's years of
recovery by the color of his/her t-shirt: 0-9 years
Green, 10-19 years Blue, 20-29 years Orange, and
30+ years Gold.
Health Care Foundation
Recovery Honor Guard
Celebrating Recovery
Entertainment  Refreshments
Silent Auction  Fellowship
Health Care Foundation
Illinois Institute for
Addiction Recovery
Schedule of Events
Registration:
10:00 a.m.-12:00 p.m.
Entertainment with Central Time Zone
Magician Gordon Snow
Balloon Creations with Terry Sherbeyn
Face Painting and our Silent Auction
$15 per person, $10 (12 & under),
$40 Family
11:00 a.m. 2009 Walk Steps-off!
12:00 p.m.
30th Annual Celebration begins
Lunch
Entertainment with Danny Blakey
Keynote speaker Dr. Arthur Trotsky
Internationally known, Dr. Trotzky is a therapist and case manager in the
Impaired Professionals Program at Ridgeview Institute in Smyrna, GA.
To guarantee your t-shirt size and color,
please register by September 2, 2009
Address __________________________________
To pay by credit card call 1-800-522-3784
State __________________ Zip ______________
Please make all checks payable to:
The Proctor Health Care Foundation
T-Shirt pick-up:
Why Walk for Recovery?
For more information
please call (309) 693-0414
City _____________________________________
Email ____________________________________
Phone ___________________________________
Please check one:
 Individual Walker
 Family
 Stepper! (team)
Team name __________________________________
 Donor amount enclosed $ ___________________
 I’m also a member of the Honor Guard
Please check one:
 0-9 years  10-19 years  20-29 years  30+ years
Since 1979, The Illinois Institute for Addiction Recovery
(IIAR) has helped thousands of adults and adolescents
begin leading comfortable, productive lives without the
use of mood-altering drugs or activities. Treating the
disease, the patient and the family.
Visit us online at
www.addictionrecov.org
and www.proctor.org
Mail with payment to:
The Proctor Health Care Foundation
5409 N. Knoxville Ave., Peoria, IL 61614
Name ____________________________________
Thursday, September 24 from 2:00 p.m.-8:00 p.m.
or the day of Walk at the Illinois Institute for
Addiction Recovery at Proctor Hospital
We need your help to remove barriers to recovery and
open new doors for those still struggling with addiction.
Please support the Illinois Institute for Addiction
Recovery and the Ameel Rashid Scholarship for
Addiction Recovery by pledging your personal support
REGISTRATION FORM
All participants receive t-shirts!
Dr. Trotsky received his B.A. in Psychology from New York University;
M.A. in Counseling and Psychology; University of Bridgeport in
Connecticut; Ph.D. in Counseling and Psychology from Oregon State
University; Post-doctoral work in addiction treatment from Mercer
University and Charter Medical.
Recovery Walks! 2009 is an opportunity to celebrate
recovery in motion one step at a time. Proceeds from
the walk benefit the Ameel Rashid Scholarship for
Addiction Recovery. The scholarship helps individuals
who are appropriate for treatment services at the IIAR
but are unable to meet the financial requirements.
Recovery Walks! 2009
T-shirt size(s) please notate quantity; color will be gray
unless Honor Guard color is indicated.
Adults
S ___
M ___
L ___
XL ___
XXL ___ XXXL ___
Youth:
M ___ L ___
Release and waiver: For in consideration of my participation in
Recovery Walks! 2009, I hereby for myself, my heirs, administrators, and
assigns, release and discharge Proctor Hospital and all involved sponsors
and their respective servants, agents, employees, officials and officers,
from any and all claims, demands, liabilities, loss, damage and causes of
action of any sort, including attorney’s fees for injuries sustained to my
person and or property incurred by reason of my participation or preparation for the above said event due to negligence or any fault. I certify
that my participation is free and voluntary. I have read and understand
the release and waiver.
Sign and date _______________________________________________
Parent’s signature (if under 18 years old)_________________________
Total registration:
$ __________
Amount enclosed:
$ __________  check  cash
Credit card:  MasterCard  Visa  Discover
Name as it appears on card: ______________________
Card number: __________________________________
Exp. date: __________ Three-digit code: ___________
(last three digits on back of card)
Signature: _________________________________