Dog Walk Registration - AIDS Response Seacoast

Take a Step to End the Epidemic
STEP 1—DECIDE TO WALK!
One more person does make a difference! Last year, the Walk
raised enough money to educate an additional 1,000 people in
the Seacoast community about AIDS prevention.
STEP 2—GET SPONSORS & PLEDGES
Ask all your family, friends, neighbors and co-workers to support
you. Ask them to pay when they pledge you.
STEP 3—FILL IN THE SPONSOR FORM
Record sponsor information on the sign-up form or your personal
Walk website. Make checks payable to ARS.
STEP 4—BRING THE FORM & PLEDGES
Check in at 1:00p.m., Portsmouth City Hall, with your form and
pledges, rain or shine. Enjoy FREE food, drink, music, and
more!!!!
STEP 5—HAVE FUN AND WALK!
The 5k Walk winds through historic Portsmouth.
Fund Raising Tips
ALWAYS CARRY YOUR SPONSOR PLEDGE
FORM: Some of the best opportunities to get donations come
unexpectedly.
SEND LETTERS AND EMAIL: Ask far-away folks to
sponsor you. They’ll be pleased to hear from you and you’ll be
impressed by their generosity.
KNOW THE BASICS—QUOTE THE FACTS: Let
people know that the fight against AIDS is far from over. See back
for facts.
SHARE WHAT THE WALK MEANS TO YOU: Relate
your reasons for joining the AIDS Walk; share your beliefs.
INVOLVE YOUR FRIENDS: Ask your friends to join you;
challenge your sponsors to find one other person who will pledge
a matching donation.
Please bring all donations to the walk.
Facts about AIDS
40 million
People worldwide have been infected with HIV
since the epidemic started.
Over 50,000
New HIV infections occur in the United States
every year.
50%
Of the new HIV infections each year in the U.S.
are among youth under 25 years old.
$4,000
Is the cost to just manage the case of one
person living with HIV/AIDS on the Seacoast.
$40
Is all it costs ARS to educate one person on
the Seacoast about AIDS prevention.
For more information:
Call AIDS Response-Seacoast
603-433-5377.
All proceeds from the Seacoast AIDS Walk
benefit AIDS Response Seacoast to provide
education and prevention programs throughout
the community, case management and
nutritional counseling for those living with
HIV/AIDS.
Sunday May 3th, 2015
Portsmouth City Hall
5K Walk Begins at 2 PM
Check-in at 1 PM
Entertainment
Complimentary Food & Drink
Special Category for Dogs
Free T-shirt for Walkers
Incentive Prizes!!!
For more information:
www.AIDSResponse.org
Or call 603-433-5377
To Register / Donate go to:
www.ARSWalk.kintera.org
Walk Registration Fee:
Adults $20
12 and Under $10
Dogs Name ___________________________________________ Walk Registration Fee:
Adults $20
12 and Under $10
Walkers Name: ________________________________________ Address: _________________________________________ ________________________________________ Please make checks payable to: AIDS Response Seacoast 7 Junkins Ave. Portsmouth, NH 03801 603‐433‐5377 x 2230 Telephone: _________________________________________ Email Address: ________________________________________ Team/Company ________________________________________ Sponsor’s Name (please print) Phone Amount (please prepay) Company Matching Donation My Own Pledge Address Collect & Bring Donations to the Walk ‐ Total $ Signature:___________________________ Date: _________________ __________ THANK YOU FOR YOUR SUPPORT!!
Parents Signature if under 18 WAIVER: Read carefully before registering. I wish to enter and participate in Seacoast AIDS Walk (SCAW) on May 5, 2013. I, the participant (and parent or guardian if participant is younger than 18 years of age) intending to be legally bound, for myself, and my heirs, executors and administrators, waive, release and forever discharge any and all rights or claims for damage which I may have or which hereafter accrue to me against any and all person(s), organizations and legal entities affiliated with SCAW, and more particularly the employees, volunteers, officials and officers of AIDS Response Seacoast (ARS) and its Board of Directors, the City of Portsmouth, New Hampshire, its City Council, Seacoast AIDS Walk, its sponsors, individually and as a whole, together with their representatives, officers, agents, employees, successors, assigns and/or sponsors, for any and all damages which may be sustained or suffered by me in conjunction with my entry in, or arising out of, my travel to, participation in, or returning from said event. I hereby agree to release to Seacoast AIDS Walk full and exclusive rights to record my performance in this event on film, videotape or still photography for use without compensation. I understand that this is an athletic event and hereby certify I am properly conditioned to participate in and compete in this event. This release extends to all claims of any kind and nature whatsoever, whether known or unknown. I understand and acknowledge, by my signature hereon, that I am waiving my right to assert any claim or cause of action against Seacoast AIDS Walk in exchange for my participation in this event. Also by my signature, I acknowledge that I have read and understand the contents of this waiver and have either sought independent legal counsel regarding the advisability of execution this waiver or have elected not to seek such counsel. I also understand that if, for any reason, this waiver is held to be void, voidable, against public policy or unenforceable, I am waiving my right to have any claim I may assert arising from my participation in this even determined by a jury of my peers and may only have my claims adjudicated through final, binding arbitration in Rockingham County, New Hampshire. Count
Cash
Checks
A/R
Total
Verify