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The MARC Foundation
for the benefit of
Mid Hudson Addiction Recovery Centers, Inc.

Walk for Recovery

Saturday - September 17, 2011 - 10:00 AM

Please use Registration form below

or download a PDF of the registration form now.
Prefix:
First Name: *
Last Name: *
Phone Number: *
E-mail Address: *
Street Address: *
Address Line 2:
City: *
State: *
Postal Code: *
Age if under 18:
Suggested Contributions: When making a donation please indicate on the Donation site under Special Instructions WALK FOR RECOVERY *
$25.00 Walker
$50.00 Walker/Patron
$75.00 Walker/Patron Angel
$100.00 Walker/Patron Saint
$1000.00 Event Marquee Sponsor
$100.00 Mileage Marker Sign Sponsor
$500.00 T-Shirt Sponsor
Other Amount
Other Amount $
Program Booklet Ad:
$200.00 Full Page
$150.00 Half Page
$100.00 Quarter Page
$75.00 Business card
Attach a File (For ads, Please upload camera ready art or send business card by September 2):
Business Sponsor Name:
Sponsor Street Address:
City:
State:
Zip Code:
Phone:
E-mail:
Donation:
Grand Total Donation:
Other Comments

* Required

 

For questions email spressman@csdsl.net.

Thank you for caring!

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