Race for Women's Health
Individual Sponsor Sheet
Saturday, April 24, 2010
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 sponsor donations
are due race day.
- Questions? Call Shiloh Erdley at 570-713-4189 or e-mail 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.)