MHA Fredericksburg Walk 2010 online registration form

WALK 2010

It’s easy to participate:

Step 1: Register today!
Register online. Registration and pledge forms are available on our website www.mhafred.org/walk2010. Email mhafred@mhafred.org or call MHAF at 371-2704 and we’ll mail forms to you.

Step 2: Collect Contributions!

Set A Goal! Aim high and help us reach our goal of $100 per walker.
Ask your family, friends, neighbors, and co-workers to sponsor you
Use the Contribution Form (step 2) to record and collect your donations
Submit form & monies to MHAF office before April 20th to ensure receipt of commemorative t-shirt for those who raise $50 or more
Or return forms & donations on Walk Day at 9:00am; shirts if available
Together we can, and will, make a difference!

Step 3: WALK on May 1st!
Experience the Walk and celebrate mental health. Make it an opportunity to connect with friends and enjoy a day together!

Step 4: Celebrate! You Did It!
You supported the free programs and services of MHAF that help people in our community everyday! FOR MORE INFORMATION:
Call MHAF at 540-371-2704 mhafred@mhafred.org www.mhafred.org

Sign up Today! Walk for Mental Wellnes Registration Form

Name:
Street Address:
City:
State: Zip:
DayPhone:
Evening/Cell Phone:
Email:

I will be walking as an individual a team captain a team member

If you are on a team, complete the following: Team Name:
Representing (company, church, school, etc.):
Team Captain Name:
Participants who raise $50 or more, select size:
S M L XL
I am unable to walk but
I am making a donation (click on Donate)

I want to volunteer at the Walk
I will donate - prizes,silent auction items
other (please specify)

Authorization
I grant fill permission for organizers to use photographs of me and quotations from me in legitimae accounts and promotions of this event. Name (Parent/guardian if under 18) Date:

Step 2. Walk for Mental Wellness Contribution Form

(You can also complete the from you download from Walk Brochure and bring it to the Walk.)

AIM HIGH - HELP US REACH OUR GOAL OF $200 per walker!

Name:
Street:
City: State: Zip:
Email:
My Fundraising Goal is:
My contribution:
Contributor   1: Donation $
Contributor   2: Donation $
Contributor   3: Donation $
Contributor 4: Donation $
Contributor   5: Donation $
Contributor   6: Donation $
Contributor   7: Donation $
Contributor   8: Donation $
Contributor   9: Donation $
Contributor 10: Donation $
Contributor 11: Donation $
Contributor 12: Donation $
Contributor 13: Donation $
Contributor 14: Donation $
Contributor 15: Donation $
Total Enclosed $
Please make checks payable to MHAF or donate online by clicking on Donate.
2217 Princess Anne St. 219-1 Fredericksburg, VA 22401