Greensburg Y.M.C.A. Aquatics Logo Brian J. Downey Memorial Lake Side 5k Walk Logo

September 13, 2008 - Rain or Shine
Twin Lakes Park Activity Center
 

Official Contribution Form   Please print
Please present this form on the day of the walk.
 
Participant’s Name: ______________________________________
Team Name: ____________________________________________
 

Sponsor’s Name

Pledge Amount

Paid Cash/Check

1.

$

2.

$

3.

$

4.

$

5.

$

6.

$

7.

$

8.

$

9.

$

10.

$

11.

$

12.

$

13.

$

14.

$

15.

$

Page Total

$

  
Make checks payable to: Special Olympics Westmoreland County

Please photocopy this form for additional sponsors as needed.
 

The official registration and financial information of Special Olympics Pennsylvania Inc. and the Greensburg Y.M.C.A. may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, 1-800-732-0999. Registration does not imply endorsement.