FREE
VENT
E
Y
L
I
FAM
PEARSON PTA
HEALTH FAIR AND
SILENT AUCTION
April 30 from 6-8 pm at the school parking lot
Family Fun Walk
 Photo Booth
 Arts and Crafts
Healthy Snacks provided by Medical
City Children's
 Plano Police
 Plano Fire Department
 Plano Dance Theater
 Snowball Express
 Blue Cross Care Van will be onsite
for immunizations—bring your shot
records
And much more!!!


Health Fair Sponsors
and Silent Auction
Donations include:
 Imagine Solutions
 EPI
 Medical City
Children’s Hospital
 Market Street
 Blue Cross Care Van
 Ridley Insurance
Agency
 Plano Dance Theater
 Disney Land
 Pet Paradise
 FC Dallas
 Dallas Zoo
 Kid Mania
 Hawaiian Falls
 Dallas Mavericks
 Speech and
Occupational
Therapy of North
Texas
 Red Lobster
 Kidkraft
 Pump It Up
 Raising Canes
Questions?
Contact: Nelly Castillo [email protected]
Peacock Promenade
Registration
Walk will start at 6:10 pm on April 30th
First Name:
Last Name: _______________________________________
Is participant over 18 years old as of 04/04/2009?
First Name:
Yes
No
(please circle one)
Yes
No
(please circle one)
Last Name: _______________________________________
Is participant over 18 years old as of 04/04/2009?
First Name:
(please circle one)
Last Name: _______________________________________
Is participant over 18 years old as of 04/04/2009?
First Name:
No
Last Name: _______________________________________
Is participant over 18 years old as of 04/04/2009?
First Name:
Yes
Yes
No
(please circle one)
Last Name: _______________________________________
Is participant over 18 years old as of 04/04/2009?
Yes
No
(please circle one)
Preferred contact info (address, phone or email):
Emergency contact phone #:
Preferred contact info (address, phone or email) :
WAIVER STATEMENT: Entry invalid if not signed. In consideration of the acceptance of this registration entry, I the undersigned
assume full and complete responsibility for any injury or accident, which may occur during my participation in the event or while I
am on the premises of the event. I hereby release and hold harmless PISD, Pearson ECS, Pearson ECS PTA, and all other persons
and entities associated with the event or their agents or employees, or otherwise. I will not enter and participate unless medically
and properly trained. I hereby affirm that my participation is strictly voluntary. I also know that although adult volunteers and highschool students will be providing course guidance, there may be traffic on the course route. I assume the risk associated with this
event, including but not limited to falls, contact with participants, the effects of weather including high heat and/or humidity, an
the conditions of the course, all such risks being known and appreciated by me.
I have read the forgoing and certify my agreement by this signature, and my parent's/ guardian's if under 18.
Signature: X ____________________________________________ Date: _________________