Registration Form Lake Middle School PTA FUNd Run/Walk

Friday, May 20, 2011

Registration Form and Donations Due By Friday, April 29, 2011
I will be running, jogging or walking in our FUNd Run/Walk on May 20, 2011. This is an important fundraiser for my school because 100% of the funds collected will go to the Lake PTA to support teacher requested materials and activities. Every student is encouraged to collect $60 or more. I hope you can help by sponsoring me! Your donation may be tax deductible. Receipts available for any individual donation of $250 or more; for lesser amounts your cancelled check is your receipt.

Participants Name:______________________________________ Address:___________________________________________________ Teachers Name___________________________________________ Phone (home): ____________________________________ Phone (cell):______________________________________ Gym Class Hour: _______ Gym Class day: A______B_________

City, State, Zip:__________________________________________________ Email Address:__________________________________________________

(Email addresses will not be sold or traded. They will solely be used to confirm your registration and to contact you regarding the FUNd Run/Walk.)

Shirt Size (please select one) Small______ Medium____ Large_____ X-large____ 2x Large_____

Please make checks payable to Lake Middle School PTA. Please submit your completed registration form and payments in an envelope addressed to the Lake Middle School PTA Attn: FUNd Run/Walk and drop it off at the main office.

Questions should be directed to Cheryle Carter FUNd Run/Walk Co-Coordinator for Lake Middle School participants: healthylifestyles@lakepta.org or call 651-560-0118.

Sponsors

Name (Printed)

Mailing Address

Email Address

Donation

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