SPONSOR REGISTRATION Dear 2015 Sponsors, NAME________________________________ ADDRESS______________________________ CITY__________________________________ STATE____________ ZIP_______________ PHONE________________________________ EMAIL________________________________ As a Sponsor, I will offer a donation of $_______ (minimum $100) to the Children’s Dyslexia Center of Portland’s Annual Walk/Run 5K on Saturday, May 9th. Please make checks payable to: CDCP 1897 Congress Street, Portland, Maine 04102 We are a 501©(3)non-profit organization and pledges are tax deductible. Dust off your walking shoes for the Children’s Dyslexia Center of Portland’s Annual “Roots to Wings” Run/Walk 5K held on May 9th at Portland’s Back Cove. This Walk/Run 5K is a community fundraising event to support the Children’s Dyslexia Center of Portland. The 5K course follows the scenic shore of Back Cove in Portland and is open to all who would like to participate! Registration for the walk/run is $15 for adults and $8 for children 12 and under. T-shirts are given to all who register. The Children’s Dyslexia Center of Portland supports dyslexic children through intensive tutoring to help them read and write AT NO COST, so we need your support! Please visit www.cdcp.me for more information about how you can help “break the code of reading” in our community! Please support this educational journey and walk with us! Together we can…. BREAK THE CODE OF READING The Children’s Dyslexia Center of Portland 1897 Congress Street Portland, ME 04102 (207) 773-4949 www.cdcp.me CHILDREN’S DYSLEXIA CENTER OF PORTLAND “Roots to Wings” 2013 WALK/RUN 5K DATE Saturday, May 9th, 2015 LOCATION Portland’s beautiful Back Cove REGISTRATION 9:00 am Back Cove (Parking lot across from Hannaford on Preble Street) 9:30 am Walk/Run Begins FMI www.cdcp.me (207) 773-4949 INDIVIDUAL REGISTRATION NAME_________________________________ ADDRESS______________________________ CITY__________________________________ STATE____________ ZIP_______________ PHONE________________________________ E-MAIL________________________________ REGISTRATION: $15 Adult x _____ = $__________ $7 Children x_____ = $ _____________ (12 and under) T-shirt Size: Sm___; Med___; Lg___; XL___; XXL____ Make checks payable to: CDCP 1897 Congress Street Portland, Maine 04102 We are a 501c (3)Corporation. Your sponsorship is tax deductible. Participant Liability Agreement: Please enter me in the “2013 Walk/Run 5K”. I, on behalf of myself, my heirs, executors, and administrators, hereby release the Children’s Dyslexia Center of Portland from any and all claims, damages, and rights of action I may have, present or future, that may arise out of, or be incident to my participation in this event. In addition, I grant permission for the use of my name and/or picture in any photograph, film or videotape of the event for any purpose. Signature (parent or guardian if under 18 years of age) WHO WE ARE PLEDGE FORM The Children’s Dyslexia Center of Portland opened in 2002 to meet the needs of struggling readers. CDCP provides quality, state-of-the-art remedial education to children diagnosed with dyslexia, helping them to learn to read and reach their full potential. Walker’s Name:_____________________ Address:______________Phone:_______ My Fundraising goal is $______________ Name: ______________________________ Phone: ______________ Amt:$___________ Name: ______________________________ Phone: ______________ Amt:$___________ The CDCP provides one-on-one tutoring for children with language-based learning problems of the type typically referred to as dyslexia. Name: ______________________________ Phone: ______________ Amt$____________ It is also a training center for teachers and educators who wish to become certified in the Orton-Gillingham approach to teach reading. These services are provided freeof-charge to the children and trainees. Name: ______________________________ Phone: ______________ Amt:$___________ Through this work, our goals at CDCP are slowly but surely becoming realized- not only to help each and every student end frustrations, guilt and disruption caused by dyslexia, but also by raising awareness of dyslexia in our community. Thank you for your support of “Roots to Wings” ! Name: ______________________________ Phone: ______________ Amt:$___________ Name: ______________________________ Phone: ______________ Amt:$___________ Name: ______________________________ Phone: ______________ Amt:$___________ Name: ______________________________ Phone: ______________ Amt:$___________ Make checks payable to: CDCP 1897 Congress Street Portland, Maine 04102 “Life is a better place when you can read.” - Matthew, age 6 We are a 501c (3) Corporation. Your sponsorship is tax deductible. Pledges will be collected when you check in.
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