Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

Access Medical Rehab proudly sponsors

Celebrity Walk n Roll for FSH Muscular Dystrophy

PRIZES GAMES

MUSIC AUCTION

Join over 20+ Celebrities & Athletes for a FUN day raising funds !
Date: Time: 10 am -2 pm 10/12/2014 Heritage Park 14301 Yale Ave, Irvine, CA 92604

FSHD is a progressive muscle wasting disease. Please help us find a treatment or cure. Proceeds to benefit The FSH Society, Inc. www.fshsociety.org
Lists the FSH Society, Inc. as 4 stars: and one of Top Ten Charities worth watching

Registration (Walk only) $25x___=$___ *VIP Reg. (see below) $50x___=$___ Children 12 & under lunch $10x___=$___ Children 12 & under (Walk only) FREE *Active Military & Family $28x___=$___ *VIP Team of 20 Military ___ =$500 *VIP Team of 20 discount ___=$900

Name - Please Print Address

Mail & Pay to: FSH Society, C/O Amy Bekier POB 500880, San Diego, CA 92150 OR online www.fshsociety.org/irvinewalk

*VIP Reg.: T-shirt, Lunch, Opportunity Drawing for 32 flat screen TV (must be present)

Phone Email Credit Card # Exp date

I waive all claims against the FSH Society & event sponsors for injury that may arise during this event. I grant permission to Visa MC Amex Disc use written, oral & visual media from me & my family in stories & promotions.

Amt Authorized

Signature

Date

You might also like