BHSP 5K RUNNER SPONSOR LIST

1 Name Address City / State / Zip G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check G Cash G Check
TOTAL

Amount Collected

Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z

2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sponsorship donations can be mailed until October 12, 2012 or presented on race day. A prize valued at $200 will be awarded on Race Day to the person who collects the most sponsorship donations overall, but at least $250. Thanks and good luck!

Name of Person Running/Walking in Race: _____________________________________________________________________ Your Name ___________________________________ Your Phone Number: _____________________________

Youre there!

A prize valued at $200 will be awarded on Race Day to the person who collects the most in sponsorship donations, but at least $250.
Donations are tax deductible. Checks should be made payable to BHS Preservation and mailed to: BHSP 5K Pirate Run P. O. Box 321 Bath, NC 27808
Please attach additional sponsor list(s) if necessary. Friends and family can visit www.BHSP5K.com for easy online donation options. Thank you and good luck!