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Participant's
Name:
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Address:
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Phone:
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Sponsor's
Name
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Full
Address
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Postal Code
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Amount
Pledged
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Receipt?
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| 1) |
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| 2) |
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| 9) |
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| *For
Pledges of $10.00 or more a tax receipt will be issued
if requested above |
Total
Pledged |
$ |
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IMPORTANT - Pledge money must be received on or
before race day in the following ways:
1) You can
drop it off at the St. John Ambulance office on 250 Gage Ave.,
Kitchener
2) You can bring it with you when you pick
up your race kit.
3) Teams - Please register
together. Entry fee will be "4 @ $40.00" or "4 @ $50.00"
depending on the date submitted.
4) Entry fees will
be waived for school teams if team pledges equal $250.00 or
more
5) Entry fees will be waived for open or
corporate teams if team pledges equal $400.00 or
more
6) Entry fees will be waived for individuals if
pledges equal $100.00 or more
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