Race for Women’s Health
Individual Sponsor Sheet
Saturday, April 30, 2011
Sponsorship covers the 5K Race or
the 2-Mile Fun Walk
- Proceeds go to Family Planning Plus, supporting a wide range of health services for women
in a five-county area.
- Checks
payable to: Family Planning Plus
- All
sponsors donations are due race day
- Questions? Call Shiloh Erdley at 570-850-0972 or shiloherdley@yahoo.com
An award will be given to the individual who raises the most sponsor dollars!
Name
of Participant_____________________________________________________
Name
Address
Phone
Sponsor Amount
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Total:________________
Sign: _________________________________________________Date:
___________
(For additional space, please use the back of this form.)
