15th Annual Chatham 5K/1-Mile Race/Walk

October 12, 2013

Donation Commitment Form
Business Name: ________________________ . Owner Manager . Address: _____ _______________________ . City, State Zip: ___ ________________________ . Phone/FAX: (_ _ _) FAX (_ _ _) _ _ _-_ _ _ _ E-Mail: __________________________________________

Race Patron

$500.00

Business Name & Logo on Race T- Shirts (back), if received by SEPT 12, 2013. Logo items (brochures, notepads, balloons, pencils, key chains, etc.) will be placed into the official race packet. Items must be available no later than October 11, 2013. PLEASE INDICATE T-SHIRT SIZE: S / M / L / XL / XXL (CIRCLE ONE) Please remit three business cards with this commitment form.

Race Donor

$250.00

Business Name only on Race T-Shirt (back), if received by SEPT 12, 2013. Logo items (brochures, notepads, balloons, pencils, key chains, etc.) will be placed in the official race packet. Items must be available no later than October 11, 2013. Please remit three business cards with this commitment form.

Race Friend
Name to be placed in the Chatham Star -Tribune Newspaper Other Level of donation:

$100.00
______________

By signing below, I agree to pledge the amount indicated above for the purpose of raising funds for the Chatham 5 K Race, Oak Grove Renovation Project, Chatham Rescue Squad, and the Chatham Volunteer Fire Department. Proprietor or Manager Signature Sponsorship Committee Signature

For further information contact Paul Nicholson 434-489-9480. Tax ID number will be made available for taxdeductible contributions. E-Mail: paul@wepresentyou.com

Chatham 5K Race Sponsorship Committee Use Only Date Contacted: _______________(get 3 business cards) Pledge Amount: _______________ Date Pledge Received: __________ Participate in Door prizes (Y or N) Door prize pick-up date: ____________

Make Checks payable to: Chatham 5K Race (Mail to:) 702 S. Main Street Chatham, VA 24531