DELA-Cares FOR KIDS WALK-A-THON

DELA-Cares FOR KIDS WALK-A-THON

REGISTRATION FORM

WALKER’S INFORMATION:

First Name: __________________ Last Name:__________________

Phone Number: __________________

Email: __________________________

Address: _____________________________________________

City: ___________________________ State: ______ Zip Code: ______

Sponsored By:	Money Pledged Per Lap	Overall Pledge Amount
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
	$1 $5 $10 $15 $20 $25 Other: $	$1 $5 $10 $15 $20 $25 Other: $
Total laps: _______________ Money due: September 26^th Donation Amount: ________________ Sponsored walkers will be notified at the walk or by phone with amount due.All donations payable to Saint Elizabeth High School attn: Walk-a-thon