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Call to ACTC ion . 5K RUN/1.5 MILE WALK FOR HUNGER AWARENESS. REGISTRATION FORM 2013. EVENT INFORMATION. Date: Saturday, June 1, 2013 at 8:00 p.m. Race Day Check-in: Saturday, June 1, 2013 at 7:00 a.m.–7:45 a.m .

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REGISTRATION FORM 2013

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Registration form 2013

Call to ACTCion

5K RUN/1.5 MILE WALK

FOR HUNGER AWARENESS

REGISTRATION FORM 2013

EVENT INFORMATION

Date: Saturday, June 1, 2013 at 8:00 p.m.

Race Day Check-in: Saturday, June 1, 2013 at 7:00 a.m.–7:45 a.m.

Location of Race: Goucher College, 1021 Dulaney Valley Road, Towson, MD

All Proceeds Donated to: Assistance Center of Towson Churches

Registration Fee: $25 Minimum for adults and $20 for ages 18 & under

Race Number & T-shirt Pick-up: Friday, May 31, 4:00 p.m. to 7:30 p.m. Thompson Hall, Towson Presbyterian Church, 400 W. Chesapeake Ave., Towson, MD 21204

There will be a Timing Clock at the finish line. Prizes will be awarded.

REGISTRATION INFORMATION

Name: _____________________________________________________________________________________________

Phone: _________ -__________-___________ Email: ____________________________________________________

Address: __________________________________________________________________________________________

_____________________________________________________________________________________________________

Age: _____ T-shirt Size: ___S ___M ___L ___XL ___2XL

Method of Payment: _______Cash ____________Check# Total: ___________

Please mark which event you are participating in: ______Run _____Walk

Payment Information: The Entry Fee can be in the form of cash or check from you or funds from your sponsors and donors (please see SPONSOR/DONOR FORM). We cannot guarantee T-shirts for Event Day registration.

Please make checks payable to: Call to ACTCion.

WAIVER FORM

All Participants Must Sign the WAIVER Below:

In consideration of this entry, I hereby for myself, heirs, executors and administrators waive and release any liability, claims or demands that I may have against any person or persons affiliated with Goucher College, Towson Presbyterian Church and/or the Assistance Center of Towson Churches from the Call to ACTCion Event. I certify that I am physically able to participate in the event.

Signature of Participant: ____________________________________________________________ Date: _____________

Signature of Guardian (if participant is under 18): _______________________________ Date: _____________

Please complete the above information, attach payment, and send to the following address:

ACTC

c/o DotsieBregel

401 Chesapeake Ave.

Towson, MD 21204

Web page: www.actconline.info Contact Dotsie: 410-583-1530

(Over)


Registration form 2013

Call to ACTCion

5K RUN/1.5 MILE WALK

FOR HUNGER AWARENESS

SPONSOR/DONOR FORM 2013

PARTICIPANT INFORMATION

Name: ______________________________________________________________________________________

Phone: _________ -__________-___________ Email: ____________________________________________

Address: ___________________________________________________________________________________

______________________________________________________________________________________________

PARTICIPANT REQUIREMENTS

Please collect all sponsor and donor contributions in advance and mail them to the address listed at the bottom of this form. You may also choose to turn them in at the appropriate registration table the day of the Run/Walk. The registration fee can be made by the participant or can be offset by sponsorship funds. It is our hope that participants will exceed the minimum requirement of $25 for adults or $20 for ages 18 and under by raising additional funds through sponsors.

SPONSOR INFORMATION

SPONSOR NAME AND ADDRESS DONATION AMOUNT CASH/CHECK# 1. ___________________________________________________________________________________________

2. ___________________________________________________________________________________________

3. ___________________________________________________________________________________________

4. ___________________________________________________________________________________________

5. ___________________________________________________________________________________________6. ___________________________________________________________________________________________7. ___________________________________________________________________________________________8. ___________________________________________________________________________________________9. ___________________________________________________________________________________________ 10.__________________________________________________________________________________________

Please complete the above information, attach payment and send to the following address:

ACTC

c/o DotsieBregel

401 Chesapeake Ave.

Towson, MD 21204


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