Family Express

Campbell and Associates-Realtors & Appraisers

Clark W. Holesinger-Attorney at Law
Vouga, Melton and Kyres-Attorneys at Law
Harper and Rogers-Attorneys at Law
Crist Tipton Painting Co.
Delta Theta Tau, Philanthropic Sorority

6.

5.

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3.

2.

1.
recovery.
The help you’ve provided to those in
Celebrate!

pledges in a secure envelope to:

the walk, mail the enclosed form and
of the event. If you are unable to attend
Bring your pledges to the walk on the day
Attend the Walk
• Top Youth Fundraiser
• Top Adult Fundraiser (18+)
• Top Youth Team
• Top Adult Team (18+)
prizes.
Top individuals and teams will be awarded
Incentives
one of them to set a fundraising goal of $125.
gather and walk together. Encourage each
Your friends, family and coworkers can
Recovery reaching its fundraising goals.
Team involvement is vital to the Walk for
OR - Form a Team.
Kelly@unitedwaypc.org for instructions.
To pay by credit card email
payable to “UWPC-Walk for Recovery.”
more. Remember to make checks
a flat donation of $5, $10, $25, $50 or
neighbors to support you. Suggest
Ask friends, family, co-workers and
Recruit Sponsors
Try for at least $125.
Set your individual fundraising goal.

Walk to Help Others

Valparaiso, IN 46384-2028
Box 2028
UWPC - Walk for Recovery
OUR SPECIAL THANKS TO:

q Individual q Team: Team Name ______________________________________ Check All That Apply:

Team Captain’s Name __________________________________________________ ____ Alice’s House
First Name __________________________ Last Name ______________________ ____ Moraine House
Address________________________________ City ________________________ ____ Respite House
State ___________________ Zip ___________ Phone _______________________ ____ Share my pledge with all
E-mail ____________________________ Age _______ q Male q Female of these.

List Sponsors Below BRING THIS FORM TO THE WALK

Please fill-in your information below along with payment type RAIN, SHINE, OR SNOW!
Sponsor Name Cash (X) Check # Amount
1. $
2. $
3. $
4. $
5. $
6. $
7. $
8. $
9. $
10. $
11. $
12. $
13. $
14. $
15. $
16. $
17. $
18. $
19. $
20. $
TOTAL
All contributions are tax deductible. Make checks payable to: “UWPC-Walk for Recovery” $
In consideration of the advancement of your purpose, objective and work, and in consideration of UWPC-Walk for Recovery organizing agencies permitting me to participate in the event on behalf of myself, my heirs, guardians,
executors, administrators or assigns including attorney fees and court costs, (Collectively “claims”), I hereby waive and release all rights and claims for damages which I may have against you, as well as any other person connected with
UWPC-Walk for Recovery, heirs, executors, administrators, successors and assignees for any and all injuries which may result directly or indirectly from my participation. I further state that I am in proper physical condition to participate
in this event. Also, I give permission for the use of my name and/or picture in any broadcast, telecast or other account of this event.

Walker Signature Parent/Guardian Signature (for walkers under 18 years of age)