SWIM, BIKE & RUN FOR A CAUSE
Triathlon Pledge/Contribution Form Participant’s Name:
Phone:
Address:
City/State/Zip:
E-mail: Use this form or donate online (see reverse). Make checks payable to: Cross Island YMCA All gifts are tax-deductible to the fullest extent of the law. Tax receipts will be mailed to the full addresses below for donations $20 or more. Please write clearly.
Sponsor’s Name
Address (Street, City, Zip)
Phone
Donation
Example-Suzy Walker
101 Main Street, Apt E Bellerose, NY 11426
718-555-1212
$ 20.00
1.
$
2.
$
3.
$
4.
$
5.
$
6.
$
7.
$
8.
$
9.
$
10.
$
11.
$
12.
$
13.
$
14.
$
15.
$
TOTAL $
$
Donations must be made by June 2. Give through Crowdrise or hand /mail in off-line donations to our Member Services desk attention Jamé Krauter.
Paid
SWIM, BIKE & RUN FOR A CAUSE 9th Annual Kids
Mini-Triathlon Y Fundraiser FOR YOUTH AGES: 8-14 $20 Individual $45 per team entry Girl Scouts Sunday, June 4 8:30am: Check In 9:00am: Start
earn your Y Triathlon Badge!
Register today! Y Member Services Desk or ymcanyc.org/ minitri
Cross Island YMCA 238-10 Hillside Ave. Bellerose, NY 11426 718-551-9300 ymcanyc.org/minitri
For more information on the Triathlon or to Volunteer Kelly Donlevy [email protected]
The Facts Date:I From:I
SUNDAY, JUNE 4 8:30AM (check-in) 9-11AM (event) In the:I SMALL POOL/TRACK Register:I IN PERSON OR ONLINE
WWW.YMCANYC.ORG/MINITRI
Win:I All participants receive a
t-shirt, certificate and a badge.
Individual:I Team (2or3 participants):
$20 $45 per team entry
Fundraising $50 Participants create their Goal : own fundraising page (see below) or Per participant turn in donations (using the form on the back) by June 2. Pre-requisite:
SWIM LEVEL
Must be able to swim deep water with endurance to complete 10-16 laps of a 25 yard pool with no aid. If needed, lifeguards may remove swimmers from completing the swim portion.)
Raise $$ & win prizes!! Visit WWW.YMCANYC.ORG/MINITRI
Click Crowdrise, and "Fundraise for this Campaign," set up your fundraiser, and hit the ground running—or biking! Prizes! If you raise $50 to $100, you
Items needed to race
Bathing suit Cap Goggles Sneakers Socks Shorts
T-shirt Towel Water bottle Change of dry clothes
Time Line Swim: Small Pool Ages: 8-10 10 laps (250 yards) : 10-12min Ages: 11-14 16 laps (400 yards) : 12-14min
you will receive a restaurant gift card. And the person who raises the most will receive a special prize! Donations must be made by June 2. Give through Crowdrise or hand /mail in off-line donations to our Member Services desk attention Jamé.
Name:
___________________________________________
Address: _________________________________________ City, State, Zip____________________________________ Phone:
_________________________________________
E-mail:
__________________________________________
Date of Birth: ______________________________________ T-Shirt Size: Youth: S Adult: S
M M
L L
XL XL
I would like to register: Individual $20.00
Team $45.00
I pledge to raise $_______money for the Y Method of Payment Check (Made out to the Cross Island YMCA)
Bike: Starts in East Parking Lot and loops on 239th Street Road will be blocked with police presence (Bring own Bike & Helmet) Ages: 8-10 .5 miles (1 loop of 239 St.) Ages: 11-14 1 mile (2 loops of 239 St.)
will receive Y gear.
If you raise more than $100,
Your Information:
Run: Track - 8 laps Ages: 8-10 1 mile: 8-15min Ages: 11-14 1 mile: 8-15min All proceeds go to the Y Annual Support Campaign. At the Cross Island YMCA, no child or family is turned away because of the inability to afford a program. Through your generous support, Cross Island Y will reach our fundraising goal of $274,000 for 2016 and we can continue to ensure that everyone will have the opportunity to be a part of the Y.
Visa
American Express
MasterCard
Discover Card
Credit Card #
Exp. date
V Code
Signature
I am not able to participate in this years Triathlon: Please accept my donation towards the 2017 Cross Island YMCA Annual Support Campaign
$15.00
$75.00
$25.00
$100.00
Other $_______
Phone:
Address:
City/State/Zip:
E-mail: Use this form or donate online (see reverse). Make checks payable to: Cross Island YMCA All gifts are tax-deductible to the fullest extent of the law. Tax receipts will be mailed to the full addresses below for donations $20 or more. Please write clearly.
Sponsor’s Name
Address (Street, City, Zip)
Phone
Donation
Example-Suzy Walker
101 Main Street, Apt E Bellerose, NY 11426
718-555-1212
$ 20.00
1.
$
2.
$
3.
$
4.
$
5.
$
6.
$
7.
$
8.
$
9.
$
10.
$
11.
$
12.
$
13.
$
14.
$
15.
$
TOTAL $
$
Donations must be made by June 2. Give through Crowdrise or hand /mail in off-line donations to our Member Services desk attention Jamé Krauter.
Paid
SWIM, BIKE & RUN FOR A CAUSE 9th Annual Kids
Mini-Triathlon Y Fundraiser FOR YOUTH AGES: 8-14 $20 Individual $45 per team entry Girl Scouts Sunday, June 4 8:30am: Check In 9:00am: Start
earn your Y Triathlon Badge!
Register today! Y Member Services Desk or ymcanyc.org/ minitri
Cross Island YMCA 238-10 Hillside Ave. Bellerose, NY 11426 718-551-9300 ymcanyc.org/minitri
For more information on the Triathlon or to Volunteer Kelly Donlevy [email protected]
The Facts Date:I From:I
SUNDAY, JUNE 4 8:30AM (check-in) 9-11AM (event) In the:I SMALL POOL/TRACK Register:I IN PERSON OR ONLINE
WWW.YMCANYC.ORG/MINITRI
Win:I All participants receive a
t-shirt, certificate and a badge.
Individual:I Team (2or3 participants):
$20 $45 per team entry
Fundraising $50 Participants create their Goal : own fundraising page (see below) or Per participant turn in donations (using the form on the back) by June 2. Pre-requisite:
SWIM LEVEL
Must be able to swim deep water with endurance to complete 10-16 laps of a 25 yard pool with no aid. If needed, lifeguards may remove swimmers from completing the swim portion.)
Raise $$ & win prizes!! Visit WWW.YMCANYC.ORG/MINITRI
Click Crowdrise, and "Fundraise for this Campaign," set up your fundraiser, and hit the ground running—or biking! Prizes! If you raise $50 to $100, you
Items needed to race
Bathing suit Cap Goggles Sneakers Socks Shorts
T-shirt Towel Water bottle Change of dry clothes
Time Line Swim: Small Pool Ages: 8-10 10 laps (250 yards) : 10-12min Ages: 11-14 16 laps (400 yards) : 12-14min
you will receive a restaurant gift card. And the person who raises the most will receive a special prize! Donations must be made by June 2. Give through Crowdrise or hand /mail in off-line donations to our Member Services desk attention Jamé.
Name:
___________________________________________
Address: _________________________________________ City, State, Zip____________________________________ Phone:
_________________________________________
E-mail:
__________________________________________
Date of Birth: ______________________________________ T-Shirt Size: Youth: S Adult: S
M M
L L
XL XL
I would like to register: Individual $20.00
Team $45.00
I pledge to raise $_______money for the Y Method of Payment Check (Made out to the Cross Island YMCA)
Bike: Starts in East Parking Lot and loops on 239th Street Road will be blocked with police presence (Bring own Bike & Helmet) Ages: 8-10 .5 miles (1 loop of 239 St.) Ages: 11-14 1 mile (2 loops of 239 St.)
will receive Y gear.
If you raise more than $100,
Your Information:
Run: Track - 8 laps Ages: 8-10 1 mile: 8-15min Ages: 11-14 1 mile: 8-15min All proceeds go to the Y Annual Support Campaign. At the Cross Island YMCA, no child or family is turned away because of the inability to afford a program. Through your generous support, Cross Island Y will reach our fundraising goal of $274,000 for 2016 and we can continue to ensure that everyone will have the opportunity to be a part of the Y.
Visa
American Express
MasterCard
Discover Card
Credit Card #
Exp. date
V Code
Signature
I am not able to participate in this years Triathlon: Please accept my donation towards the 2017 Cross Island YMCA Annual Support Campaign
$15.00
$75.00
$25.00
$100.00
Other $_______
