OFFICIAL PLEDGE FORM

Bring this form and all of your
money with you on 3/19 @ 6:00
to: YMCA: 209 East Main
Street; Batavia, NY 14020
A PLAYATHON® is a fun and exciting way for kids of all ages to make a difference while they play.
Every 15-minute segment of a PLAYATHON generates funds for charity.
I will be participating in a PLAYATHON to raise funds for purchasing tents in SOS Children’s Villages in Haiti.
Would you please pledge an amount to help me support this charity? Thank you!

Participant’s Name: Address:

Sponsor Name & Address Phone Amount Per Flat Donation Cash or
Signature Segment Check
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Attention sponsors: Make your check payable to SOS Children’s Villages. Participant: Upon completion of PLAYATHON, please return pledge form and checks to:

TALKING POINTS: Genesee County Youth Bureau

• Earthquakes are measured between 1 & 9 on the Richter Scale. The earthquake Organization

that hit Haiti was a 7.0. An aftershock that occurred a week later was a 6.1. 3837 West Main Rd. Street
• SOS Children’s Villages is a non-profit organization (NGO) providing homes to Address
orphaned and abandoned children in 132 countries. It runs 2 villages in Haiti,
which target children who do not have parental care. Batavia NY 14020
City State Zip Code
• An estimated 200,000 tents are needed for the rainy season, which starts in
March. A sturdy tent for 15 children costs $2,500. A smaller one costs $1,250 Section to be completed by charity

• Hasbro will be doubling any donations received through the end of March.