Sunday October 17th 2010 9am
ALL PLEDGE SHEETS AND MONEY DUE ON DAY EVENT
WALKER/RUNNER’S NAME: ________________________________
PLEASE PRINT NAME AND FULL ADDRESS CLEARLY
ADDRESS: ______________________________________________
TAX RECEIPTS WILL BE ISSUED UPON REQUEST FOR
PHONE #: _______________________________________________
EMAIL ADRESS__________________________________________
TEAM NAME: ______________________
| SPONSOR | ADDRESS-TOWN-POSTAL CODE | PHONE # | TAX RECEIPT? | PLEDGE COLLECTED |
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16 | | | | | |
17 | | | | | |
18 | | | | | |
19 | | | | | |
20 | | | | | |
IF PAYMENT IS MADE BY CHEQUE, MAKE TOTAL: ____________
PAYABLE TO BIG BROTHERS / BIG SISTERS