Pledge Form

Please help raise money for the children at Hasbro Children's and Bradley hospitals.
Sponsor's Name Pledge per Km
or donation		 Total Sponsor's Name Pledge per Km
or donation		 Total
1. _ _ 11. _ _
2. _ _ 12. _ _
3. _ _ 13. _ _
4. _ _ 14. _ _
5. _ _ 15. _ _
6. _ _ 16. _ _
7. _ _ 17. _ _
8. _ _ 18. _ _
9. _ _ 19. _ _
10. _ _ Total. _ _

(Okay to photocopy)

First Name
 		Last Name
 		M I
Address
City
 		State
 		Zip Code
Phone
--

My pledge counts toward corporate team total. Team name ________________________________

Pledge Guidelines

Individuals: Please pre-collect all donations and turn them in with the pledge form.

Team Captains. Please collect all pledges and pledge forms for your team. If pledges are in cash, please make one check.

Pledges can be turned in at the pledge table on Saturday or Sunday at registration locations. Pledge checks may also be mailed before race day to:

Downtown 5K, Inc.
P.O. Box 1940,
East Greenwich, RI 02818-0663.

Make pledge checks payable to: Downtown 5K Children's Fund.

Free race entry for $50 or more raised in pledges

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