APPLICATION FOR:

2014 LANSDALE HOMETOWN HERO WALK

SATURDAY JUNE 14, 2014

1. Each walker donates a minimum of $20.00 ($10.00 for a youth walker) in order to receive a PA Hero Walk T-Shirt. 2. Checks should be made payable to: PA HERO WALK 3. Individual participants or team captains should complete one form for themselves or their team. Return completed form and check(s) to: PA HERO WALK c/o Bish Rieg 728 Jackson St., Lansdale, PA 19446 4. Any questions, please contact Bish Rieg (215) 362-1089 or email lansdalewalk@verizon.net 5. FORM AND DONATIONS ARE DUE ON OR BEFORE MAY 15, 2014. TEAM MEMBER? YES NO NAME PHONE EMAIL TEAM NAME TEAM CAPTAIN

AMOUNT

VET (Y OR N)

SHIRT SIZE: Specify YOUTH: YS, YM, or YL ADULT: AS, AM, AL, AXL, A2XL, or A3XL

If more names need to be listed, please attach an additional sheet or list on the back of this page. Thank you in advance for your support and efforts to help all those who have made great sacrifices for our freedom. ALL PROCEEDS BENEFI T THE WOUNDED WARRIOR PROJECT
C a p t a in s P o rt io n

Walkers Portion

DATE OF WALK: June 14, 2014 TIME: REGISTRATION FROM 8:30 TO 10:00 AM WALK BEGINS AT 10:30 AM START, END, AND POST WALK CELEBRATION: TRINITY LUTHERN CHURCH 1000 WEST MAIN STREET LANSDALE, PA 19446 PLEASE STAY TO CELEBRATE!!!!!! VETERANS PLEASE WEAR A MARK OR SYMBOL OF YOUR SERVICE!