Chesapeake Wildlife Sanctuary Pledge Application

PLEDGE SHEET ~ * ~ Walker #______________

CAN'T COME, BUT STILL WANT TO HELP?

Send a pledge and we will select a volunteer walker for you.

Walker's Name__________________________________________________

Address_______________________________________________________

Phone(day)________________________ Fax__________________________

State__________________ Zip______________________

Email______________________________________________

Total Pledges___________ Total Collected____________ Volunteer's Initials___________

WAIVER: In consideration of the acceptance of my entry, I hereby for my heirs, executers and administrators assume any and all risks which might be associated with the Walk. I waive & release any and all rights and claims of any nature for damages which I might have against the organizers and all others connected with this event, their representatives, successors and assign for any and all injuries or damages of any kind whatsoever suffered by me or my property as a result of taking part in the walk and any related activities.

Signature ___________________________________________________________________

If under 18, Parent/Guardian Signature______________________________________________

SPONSOR'S NAME

ADDRESS/CITY/STATE/ZIP

PLEDGED

COLLECTED

1 ____________________

__________________________________

$___________

$___________

2 ____________________

__________________________________

$___________

$___________

3 ____________________

__________________________________

$___________

$___________

4 ____________________

__________________________________

$___________

$___________

5 ____________________

__________________________________

$___________

$___________

6 ____________________

__________________________________

$___________

$___________

7 ____________________

__________________________________

$___________

$___________

8 ____________________

__________________________________

$___________

$___________

9 ____________________

__________________________________

$___________

$___________

10 ___________________

__________________________________

$___________

$___________

11 ___________________

__________________________________

$___________

$___________

12 ___________________

__________________________________

$___________

$___________

13 ___________________

__________________________________

$___________

$___________

14 ___________________

__________________________________

$___________

$___________

15 ___________________

__________________________________

$___________

$___________

TOTAL PLEDGED $_______________________

TOTAL COLLECTED $_______________________

Our Goal is for Each Participant to Raise at Least $100

Print Out this Form and Photocopies are acceptable.

Call 301-871-4881 or 301-390-7011 for more information. To be eligible for prizes you must turn in your pledge sheet(s) and pledge money/donations the day of the Walk. Make checks payable to CWS. Proceeds will benefit the Chesapeake Wildlife Sanctuary and are tax-deductible.

IN CASE OF RAIN - OR IF YOU CAN'T MAKE IT AT THE LAST MINUTE

Since our wildlife patients are counting on you, we ask that in the event you are unable to attend on the day of the Walk that you walk your pledged amount of miles on a later date at either Wheaton Regional Park or a location of your choice. We wouldn't want to disappoint all the baby bunnies, songbirds, fawns, ducks, geese, hawks and owls!

DIRECTIONS TO THE WALK

Capital Beltway (495) to Exit 31, Georgia Ave. North. Continue 2-1/2 miles North on Georgia Avenue. Turn right onto Shorefield Road and continue until it ends at the entrance to the park.

START TIMES

Start the Walk anytime between the hours of 10a.m. and 12noon. Since the routes are totally paved you can walk, run, skate, or even push a baby carriage. Be sure to turn in all of your pledges to qualify for some great prizes. All checks should be made payable to the Chesapeake Wildlife Sanctuary. If you are unable to collect all of your pledges before the Walk an envelope will be given to you to use to return any stray pledges. The sooner your pledge dollars are collected, the sooner they can begin working for the Sanctuary. Return your pledges in the envelope WITH your sponsor form(s) to: Chesapeake Wildlife Sanctuary 17308 Queen Anne Bridge Road Bowie, Maryland 2076-9053

~ Walk for Wildlife ~ Walk for Wildlife ~ Walk for Wildlife ~ Walk for Wildlife ~

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