4-H Walkathon
May 7, 2016
Additional registration forms available at the 4-H Office or call 885-8995
Full 5K walk See reverse side for details
Raise $50 or more and get a special
Commemorative T-shirt.
Registration: 9:30–10:00am Opening Ceremony: 10:15am Walkathon Facts
Think about asking relatives, friends, neighbors, and businesses to be sponsors. Youth walkers through age 18 must have a signed permission slip (bottom of registration form) to walk. Everyone walking, including parents walking with their children, must be registered with a pledged amount. Sponsors agree to pay the participant a set amount for the Walk. Pledges must be collected and returned to 4-H Office by May 31, 2016. There is no rain date – come prepared for any weather. Drinks, snacks, and fruit will be available during registration and at the end of the walk. All participants must return to the registration table to get their sponsor list. Certificates will be mailed to those requesting it on the registration form. Crossing guards and signs will help walkers navigate the route. A first aid person is on duty during the walk. If assistance is required, call 281-9962. No pets, horses, or bicycles are permitted.
Prizes To be eligible for prizes all pledge money must be turned in by May 31, 2016 (Additional monies turned in after this date will not count toward prizes.)
The 10 4-H members collecting the most pledge money ($100 minimum) will each receive a special gift award at Achievement Night. A $50 cash award will be given to the walkers ages 7 and under, 8-12 and 13-18, collecting the most pledge money. Awards will also be given to the club raising the most amount of money and to the club with the highest participation (percentage). Teen Council sponsors an additional prize of $100 to the teen collecting the most pledge money. It will be applied to a 4-H trip of the teen’s choice. 3 clubs (one small, one medium, and one large club) collecting the most money will be awarded a pizza prize.
Additional entry forms are available at the 4-H Office.
Registration Form Saratoga County 4-H Walkathon ______ Name_______________________________________________ Telephone___________________ Address__________________________________________________________________________ Date of Birth_____________________ Age __________
Saratoga Co. 4-H member? Yes or No (circle)
Would you like a printed Certificate of Participation? Yes or No (circle) Sponsors agree to pay the person named above the sum indicated beside their name. Donations are tax deductible. All pledges collected support the Saratoga County 4-H Training Center. Make checks payable to CCE of Saratoga Walkaton Name
Address
Amount Pledged
Amount Paid
Do Not Write in this Box I, ______________________, an official of the 4-H Walkathon, hereby certify that the participant named above completed the walk.
4-H Walkathon Parental Permission Slip (Youth 18 yrs. and under) Child’s name: __________________________________________________________ Activity: 4-H Walkathon Please list any health concerns, physical restrictions, allergies, or other information you would want the director of this activity to know regarding the welfare of your son/daughter:______________________________________________ Emergency phone numbers where parents can be reached at time of this activity:_______________________________ In the event I cannot be reached in an emergency, I hereby give permission for my child, as named above, to be medically treated by a physician or medical facility as appropriate. I permit the use of any photos, slides, films, or sketches of him/her taken during the activity for publicity, advertising, and promotion. Signature:__________________________________________________Date:________________________________
Additional registration forms available at the 4-H Office or call 885-8995
Full 5K walk See reverse side for details
Raise $50 or more and get a special
Commemorative T-shirt.
Registration: 9:30–10:00am Opening Ceremony: 10:15am Walkathon Facts
Think about asking relatives, friends, neighbors, and businesses to be sponsors. Youth walkers through age 18 must have a signed permission slip (bottom of registration form) to walk. Everyone walking, including parents walking with their children, must be registered with a pledged amount. Sponsors agree to pay the participant a set amount for the Walk. Pledges must be collected and returned to 4-H Office by May 31, 2016. There is no rain date – come prepared for any weather. Drinks, snacks, and fruit will be available during registration and at the end of the walk. All participants must return to the registration table to get their sponsor list. Certificates will be mailed to those requesting it on the registration form. Crossing guards and signs will help walkers navigate the route. A first aid person is on duty during the walk. If assistance is required, call 281-9962. No pets, horses, or bicycles are permitted.
Prizes To be eligible for prizes all pledge money must be turned in by May 31, 2016 (Additional monies turned in after this date will not count toward prizes.)
The 10 4-H members collecting the most pledge money ($100 minimum) will each receive a special gift award at Achievement Night. A $50 cash award will be given to the walkers ages 7 and under, 8-12 and 13-18, collecting the most pledge money. Awards will also be given to the club raising the most amount of money and to the club with the highest participation (percentage). Teen Council sponsors an additional prize of $100 to the teen collecting the most pledge money. It will be applied to a 4-H trip of the teen’s choice. 3 clubs (one small, one medium, and one large club) collecting the most money will be awarded a pizza prize.
Additional entry forms are available at the 4-H Office.
Registration Form Saratoga County 4-H Walkathon ______ Name_______________________________________________ Telephone___________________ Address__________________________________________________________________________ Date of Birth_____________________ Age __________
Saratoga Co. 4-H member? Yes or No (circle)
Would you like a printed Certificate of Participation? Yes or No (circle) Sponsors agree to pay the person named above the sum indicated beside their name. Donations are tax deductible. All pledges collected support the Saratoga County 4-H Training Center. Make checks payable to CCE of Saratoga Walkaton Name
Address
Amount Pledged
Amount Paid
Do Not Write in this Box I, ______________________, an official of the 4-H Walkathon, hereby certify that the participant named above completed the walk.
4-H Walkathon Parental Permission Slip (Youth 18 yrs. and under) Child’s name: __________________________________________________________ Activity: 4-H Walkathon Please list any health concerns, physical restrictions, allergies, or other information you would want the director of this activity to know regarding the welfare of your son/daughter:______________________________________________ Emergency phone numbers where parents can be reached at time of this activity:_______________________________ In the event I cannot be reached in an emergency, I hereby give permission for my child, as named above, to be medically treated by a physician or medical facility as appropriate. I permit the use of any photos, slides, films, or sketches of him/her taken during the activity for publicity, advertising, and promotion. Signature:__________________________________________________Date:________________________________
