The Amazing Adventure To End Homelessness“The Game of Life”

An outdoor, interactive team/family event!September 19, 2015 Faith United Methodist Church, Montoursville

Check-In begins at 10:00 a.m. The race officially begins at 11:00 a.m.

Team Registration Fee: $50.00 Waived if team raises over $500 in team sponsor fees Registration due by day of event

Late team registration $75.00Late registrations are not guaranteed an event bag.

Teams must be 4-8 members with at least 1 under the age of 18.The amount of starting “FP Bucks” is determined by the amount of team sponsorship.

$50.00 additional starting “FP Bucks” for every child under 18

Meeting the $500 goal is easy!There are always people who may not be able to participate in the race themselves, but who would be happy to support this worthy cause. All you have to do is ask.

Submit a completed Race Sponsor Sheet with your collected donations, and we will send your supporters a thank you letter. Their gift is tax deductible – our letter provides documentation. All it takes is for all 8 team members to get 7 people to donate $10 each or 4 people to donate $20 each.

Prizes Awarded to the Following Team with the most sponsorships

Individual with the most sponsorships

Can’t participate? We will miss you!Please consider a monetary gift to Family Promise and help us

Break The Cycle of Homelessness!

635 Hepburn St.Williamsport, PA 17701

(570) 567-7103www.familypromiselycoming.org

Registration Information

Members of the same household may register on one sheet. List each participant’s name and information. This form may be copied. All participants must enter information to participate.

Team Name: _______________________________________________________

Registration Fee: $50 for up to 8 members. Free registration with $500 in sponsorship.

First Name Last Name Birthday Known Illnesses/Allergies Signature

         

                  

                                             

Team Captain’s Name and Address: _____________________________________________________________

City:________________________ State: _____________Zip:_________________

Home Phone:______________________________ Cell:___________________________

Email Address______________________________________________

Waiver: in consideration of your acceptance of this entry, I hereby for myself, my heirs, executors, and administrators wave and release all rights for claims and damages I might have against Family Promise of Lycoming County, and to all related parties, for any and all injury or damage resulting from participating in the above event. I am in proper physical condition to participate in this event.

Photo Release: I hereby grant permission to Family Promise of Lycoming County, Inc., to take and use: photographs and/or digital images of me for use in news releases and/or promotional materials. These materials might include printed or electronic publications, Web sites or other electronic communications. I further agree that my name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of Family Promise of Lycoming County, Inc.

All adults please sign; Parent/Guardian must sign for minors.

Mail Completed Form to Family Promise, 635 Hepburn St. Williamsport PA 17701 Or Via email to familypromiselycoming@Hotmail.com