Booksin Elementary School Walkathon -- Pledge Card & Sponsor Sheet

Parental Permission: I hereby grant permission for my child to participate in the Walkathon. I have read the "Walkathon Guide" and understand the rules.

Student's Name: ____________________________________ Parent Signature: _______________________________________

Teacher's Name: _____________________________________ Home Phone: _________________ Cell: ____________________
Grade: ______ Room #: _______________________________ Work Phone: __________________ Date: ___________________

Your Donations Add Up! Money raised will go to pay for $25
various programs sponsored by BESCA, the parent, teacher
and community organization -- and fundraising body.
$50
Many critical school programs are funded by BESCA:
$100
• Technology Support • Music Enrichment • Garden Life Lab
$150
• Reading Aids/Specialists • Student Practice Workbooks
• Science Lab Supplies • School Safety Supplies • Student Planners
$200
• Art Vista Supplies • Cornerstone Program • Classroom Enrichment
• Library: Two Books • Classroom Paper & Copies
• Sponsors a less fortunate family for School Activity Nights / Yearbook
• Fun Fridays: Art & Sport Materials • Art Vistas: Classroom Art Supplies
• Booksin Garden: Supplies for one "Thriving Thursday" activity
• Science Camp: Financial Assistance for one less fortunate 5th grader
• Weekly Reader: Yearly Subscription for one Classroom
• Set of Reading Books for the Cornerstone Program
• Garden: Soil, fertilizer and flowers for three garden plots
• Field trips: Museum or Activity Admission for class trip.
• Art Vistas: Clay Supplies

Supplemented by Corporate Matching? Y WAT Committee Use ONLY

Per Mile Amount
Sponsor Name Address Telephone Flat Pledge $$ Per Mile Walked Ext Due Collected
First & Last Street Address - Zip A B C BxC A + (B x C)

Laps: __________ Miles: __________ (C) Subtotal (Front): # $ # $

Please contact us about our Corporate Matching efforts! Subtotal (Back): # $ # $
Please make checks payable to 'BESCA' TOTAL: # $ # $
Student Name: ______________________________ Supplemented by Corporate Matching? Y WAT Committee Use ONLY
Per Mile Amount
Sponsor Name Address Telephone Flat Pledge $$ Per Mile Walked Ext Due Collected
First & Last Street Address - Zip A B C BxC A + (B x C)

Need more room? Copy this Back Page and attach it with a staple. Subtotal (Back): # $ # $