Walk & Roll Corporate Sponsors Baden Coffee Company Barber Collins Security Services Ltd. Brody Enterprises Inc. Complete Hearing Health Diversey Care Giesbrecht, Griffin, Funk & Irvine LLP JIKS Industrial Kitchen Services Ltd. KR Communications Ltd. KW Insurance Brokers K-W Community Spirit Lions Lions Club of Kitchener Medical Mart Medical Pharmacies Group ProResp Qwatro-Royalpak Royal Canadian Legion Branch 530 Waterloo Scotiabank Shoppers Home Health Care Sorbara Law SYSCO Design and printing courtesy of Corporate Publishing (Region of Waterloo). 3.5k Walk & 1.5k Wheelchair Roll Saturday, June 13, 2015 A fundraiser in support of Sunnyside 247 Franklin Street North, Kitchener Tel: 519-893-8482 • Fax: 519-893-4450 www.sunnysidefoundation.ca Registered Charitable # 87728 8167 RR0001 COMMUNITY SERVICES LOTS TO DO AND SEE Foundation Annual Walk & Roll Proceeds from Walk & Roll will be used to fund ceiling lifts to Saturday transfer residents with ease and dignity and purchase towel blanket warming units. June 12,and2010 Walk & Roll has raised $650,000 over the years. This fun filled, family fundraiser contributes to the comfort, safety and quality of life for the people who live at Sunnyside Home and Supportive Housing and who participate in the Community Alzheimer Program and use the Sunnyside Wellness Centre. SCHEDULE OF EVENTS 10 a.m. Registration, pledge drop off and t-shirt pick up in Kenneth parking lot, Sunnyside. 10:50 a.m.Aerobic warm up. 11 a.m. 3.5 km walk along Franklin, Shuh, Idlewood, Glenwood Streets and 1.5 km wheelchair roll around the Sunnyside campus. 12 noon Lunch for registrants. 12:30 p.m. Prizes for top pledge collectors and door prize winners followed by a silent auction. – Additional parking available at St. Luke’s Lutheran Church on Franklin • enjoy the beautiful sounds of the Royal City Big Band •experience a therapeutic massage provided by students from the College of Massage and Hydrotherapy • see antique cars and talk to the owners • have your face painted • join the drumming circle with the Sunnyside music therapists • try your luck at the children’s games and win a prize every time PRIZES Family with the Highest Pledges Set of cedar Adirondack chairs donated by Robert Brohman Enterprises Inc. Team with the Highest Pledges Dinner for four courtesy of Edelweiss Tavern, Kitchener and admission tickets donated by Canada’s Wonderland. Individual with the Highest Pledges Amazon Kindle Fire HD tablet donated by Tom Bevenborn, KW Insurance Brokers and Sunnyside Foundation board member. Resident/Tenant with the Highest Pledges Therapeutic massage with Vassily Salytchev, RMT, Sunnyside Wellness Centre and shampoo and cut courtesy of Reflections Beauty and Barber Shop, Sunnyside. Door prize draws for registrants and volunteers donated by local businesses and friends of Sunnyside. SILENT AUCTION • Each item will have an opening minimum bid • Cash, cheque, MasterCard and Visa will be accepted PLEDGE SHEET Sunnyside Foundation Annual Walk & Roll 1. 2. 3. 4. PLEASE PRINT CLEARLY. NAMES, ADDRESSES & POSTAL CODES are required for issuing receipts for donations of $10 and over. Receipts will be issued at year end. Photocopy additional copies as required. All registrations ll, id in fu with pledges pa nnyside Su to ed er liv de and 10, 2015, ne Ju , by Wednesday in a try qualify for en . aw dr l ia spec Saturday, June 13, 2015 Participant’s Last Name: _____________________________________________ First Name:_________________________________________________ Address:__________________________________________________ City/Town: _______________________________ Postal Code: _____________ Team/Family Captain’s Name:____________________________________________________________________________________________________ PLEASE PRINT NAME ADDRESS CITY POSTAL CODE PLEDGE AMOUNT Total Brought Forward Please make cheques payable to Sunnyside Foundation Registered Charitable # 87728 8167 RR0001 AMOUNT PAID NAME ADDRESS CITY • Visa and MasterCard accepted, please include card number and expiry date • Pledges can be made online at www.sunnysidefoundation.ca/makeadonation POSTAL CODE PLEDGE AMOUNT AMOUNT PAID Total Brought Forward Partial Payment Full Payment Total pledge submission of $__________, _Signed: (participant) ____________________________________ Date _____________________ Please accept my partial submission of $__________, and I will forward the balance of $ __________ by (date)_______________. _Signed: (participant) ________________________________________ Date _________________ Please make cheques payable to Sunnyside Foundation Registered Charitable # 87728 8167 RR0001 FRE E! T-s first 2 hirts for t he 00 pa r or wh ticipants ile quan tities last REGISTRATION Last Name (Team Captain) First Name Street Address/Apt. number City Prov. Home Phone Postal Code Business Phone Email Address Individual Registration Fee: $25 ❏ Registration fee waived for minimum of $100 in pledges and your name will be entered to win door prizes. Team Registration Fee: $100 ❏ Registration fee waived for minimum of $300 in pledges ($ amounts are per team) and your names will be entered to win door prizes. Group of four (4) individuals. Family Registration Fee: $100 ❏ Registration fee waived for minimum of $200 in pledges and your names will be entered to win door prizes. Group of four (4) individuals. Team captain name: T-shirt size Team member name: T-shirt size Team member name: T-shirt size Team member name: T-shirt size T-shirt sizes: Youths S(2-4), M(6-8), L(10-12), Adults S, M, L, XL Waiver In consideration of the acceptance of my application and the permission to participate as an entrant or competitor in the 2015 Sunnyside Foundation Walk & Roll, I, for myself, my heirs, executors, administrators, successors, and assigns hereby release, waive, and forever discharge the corporation of the City Of Kitchener, the Regional Municipality Of Waterloo, the Waterloo Regional Police Force, the Region Of Waterloo Auxiliary Police Services Board, the Chief Of Police, Sunnyside Seniors’ Services, Ministry of Health and Long Term Care and Waterloo Wellington Local Health Integration Network, and all other associations, sanctioning bodies and sponsoring companies, and all their respective agents, officials, servants, contractors, representatives, successors and assigns of and from all actions, causes of action, suits, claims and demands whatsoever which I may have by reason of or in any way arising or to arise by reason of my participation in the said event, whether as a spectator, participant, competitor or otherwise; whether prior to, during or subsequent to the event and notwithstanding that same may have been contributed to or occasioned by the negligence of any of the aforesaid. I further hereby undertake to hold and save harmless and agree to indemnify all of the aforesaid from and against any or all liability incurred by any or all of them arising as a result of, or in any way connected with my participation with the said event. By submitting this entry, I acknowledge having read, understood, and agreed to the above waiver release and indemnity. I warrant that I am physically fit to participate in this event, and have attained the age of 19 years, or if not 19 years of age, my parent or guardian has signed on my behalf. I also authorize the use of any photographs of me (or my child) taken at the event for the promotion of the Sunnyside Walk & Roll. (Signed) x . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Date). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Team signatures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Team signatures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO IN-LINE SKATES OR BICYCLES
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