Saturday Morning, September 28, 2013 River Plex 600 NE Water

Saturday Morning, September 28, 2013
River Plex
600 NE Water, Peoria, Illinois
7:30 a.m.
9:30 a.m.
9:35 a.m.
9:50 a.m.
10:00 a.m.
Check-In Registration
Welcome
Guest Speaker Address: Judge James E. Shadid
Survivor Picture
Balloon Release and Walk Begins
th
All participants registered prior to August 17 will be guaranteed a “Mark Linder Walk for the Mind” T-shirt.
The Mark Linder Walk for the Mind is a one mile walk to support brain tumor research and
to raise awareness of brain tumors and their impact on those in Central Illinois.
Photo Board:
Bring pictures of those who inspired you to attend the walk. Bring your photo to the registration table. Photos may be picked
up following the walk. You may also e-mail the photo along with a note with the name and information about who is in the
photo. Email to Amanda Smith. Her e-mail is [email protected]
This year marks the 11th year for the Mark Linder Walk for the Mind.
The 1st Annual Walk for the Mind was held in 2003. Mark’s creation of the Walk
stemmed from his experience of feeling alone when he was diagnosed. His
mission was to create brain tumor awareness in the local community. Mark also
wanted to raise funds for brain tumor research. More than a decade later the
Mark Linder Walk for the mind has become instrumental in bringing individuals
together to create a network of support for one another. Many of our survivors
are now SHARING knowledge gained from experiences in dealing with their own
brain tumors.
For the first ten years of the Walk, well over $330,000
$33
was raised for brain
tumor research. At last year's Walk, we were excited to announce our newly
achieved status as a 501(c) (3) charitable organization. We also
al announced a
partnership with the University of Illinois College of Medicine. We are pleased to
continue this partnership another year. Net
et proceeds from the 2013 Walk will be
directed to the brain tumor research program being conducted in Central Illinois at
the University of Illinois College of Medicine in Peoria. We expect to see some of
the researchers again this year from the College of Medicine, Illinois Cancer Care,
and Illinois Neurological Associates.
We look forward
ard to another successful Walk and would be delighted with your
support. We encourage you to bring your family and friends to this great event.
Your continued support lends HOPE to survivors that one day a cure will be found.
Sharing Hope,
The 2013 Mark Linder Walk for the Mind Committee
MARK LINDER WALK FOR THE MIND INFORMATION:
Please contact Peggy at (309)925-3919.
(309)925
E-mail: [email protected]
www.marklinderwalkforthemind.org
Meet for the Mind is a support group that was formed after the first
walk. If you are interested in attending a Support Group Meeting
contacts are:
Abby Lotz (309)655-6864 ([email protected]
[email protected])
Sally Wecker (309)678-9688
Peggy Flannigan (309)925-3919
2013 Mark Linder Walk for the Mind Registration
tration Form
Make registration checks payable to “Mark
Mark Linder Walk for the
Mind” and mail this registration form to:
Mark Linder Walk for the Mind
P.O. Box 5522
Peoria, IL 61601
Please fill in form on backside. All participants registered prior to
August 17th will be guaranteed a Walk for the Mind T
T-shirt.
Registration fees are not tax deductible as charitable contributions for
Federal Income Tax purposes.
If you would like to make a charitable contribution for Federal Income
Tax purposes, please make a separate check payable to ““Mark Linder
Walk for the Mind”. Donations may be mailed to the Mark Linder Walk
for the Mind address.
Walker Registration: $20.00
Walkerr Registration children 10 yrs & under
under: $10.00
Survivor Registration: Free
Mark Linder Walk for the Mind Location: Riverplex, Peoria, IL
Registration & Raffle opens 7:30 a.m.
Program begins 9:30 a.m.
Saturday, September 28, 2013
Online Donation option is available at
www.marklinderwalkforthemind.org
Online registration available beginning on August 1st.
There is a nominal service charge for this service.
Visit www.marklinderwalkforthemind.org
(Rain or Shine / No refunds)
Available T-Shirt Sizes For Registered Walkers
Walkers:
 MY (medium youth sz 10-12)
 Small
 Medium
 Large
 Extra-Large
 2 XL


Wheelchairs
chairs & strollers welcome
Raffle tickets will be available.
avai
All net
proceeds benefit the brain tumor
research programs of the University of
Illinois College of Medicine at Peoria
 I/WE WILL WALK – MY/OUR REGISTRATION IS ON THE BACK
BACK.. (Please complete registration on back)
Registration checks are made payable to “Mark Linder Walk for the Mind”
 I will not be able to participate but I am submitting a contribution. My check
heck is payable to Mark Linder Walk for the Mind
Name: ___________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
Address: _________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
City State Zip ___________________________________
______________________________________________________________________________________________________________________
_______________________________________________________________________________________
Donation Amount ______________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
E-mail address: ________________________________________
_______________________________________
__ Telephone #: _______________________________________________
 I have collected additional donations. Checks are payable to Mark Linder Walk for the Mind:
Name:____________________________________________________
Name:___________________________________________________________
Name: _____________________________________________
_____________________________________
Address: ________________________________________________________
Address: ___________________________________
__________________________________________
City State Zip ___________________________________________________
City State Zip ________________
_______________________________________________
____________________________________
Amount: ________________________________________________________
Amount: ________________________
____________________________________________________
__________________________________
Additional collected donations may be listed on a separate sheet of paper.
2013 Mark Linder Walk for the Mind Registration Form
WAIVER: In consideration of the acceptance of my entry for Mark Linder Walk for the Mind, I hereby for myself, my heirs, executors and
administrators, fully and forever RELEASE, REMISE, ACQUIT AND DISCHARGE the University of Illinois Foundation, University of Illinois
College of Medicine, the Peoria Park District, the City of Peoria and the Mark Linder Walk for the Mind (including, but not limited to, any
volunteers, organizers, agents, servants, sponsors) and each of their officers, directors agents and employees from any and all claims,
demands, damages, actions or rights of action of whatever kind or nature I may now have or may hereafter have arising out of or in
consequence of all known or unknown injuries to person or damages to property resulting to me in any way from my participation in the Mark
Linder Walk for the Mind. I also grant permission to all of the foregoing to use any photographs, motion pictures, recordings or other records
of this event for any legitimate purpose.
Walker Registration Fee $20.00/Children 10 yrs old & under $10.00/No fee for survivors
Please make registration checks payable to “Mark Linder Walk for the Mind”
Registration fees are not tax deductible as charitable contributions for Federal Income Tax purposes
Name:_____________________________________________________________________________Email______________________________________________________
Address:___________________________________________________________________________Fee Enclosed $_______________ check #: _________________
City, State,Zip____________________________________________________________________ Daytime Phone __________________________________________
T-shirt size (circle one) child size 10-12/Adult Sm/Adult Med/Adult Lg/ Adult XL/Adult 2XL/no shirt
Brain Tumor Survivor: Yes No (No registration fee for brain tumor survivors)
Participant Waiver Signature(required)___________________________________________________________________
Guardian Signature (if participant is under18)____________________________________________________________________________________________
Name:_____________________________________________________________________________Email______________________________________________________
Address:___________________________________________________________________________Fee Enclosed $_______________ check #: _________________
City, State,Zip____________________________________________________________________ Daytime Phone __________________________________________
T-shirt size (circle one) child size 10-12/Adult Sm/Adult Med/Adult Lg/ Adult XL/Adult 2XL/no shirt
Brain Tumor Survivor: Yes No (No registration fee for brain tumor survivors)
Participant Waiver Signature (required)__________________________________________________________________________________________
Guardian Signature (if participant is under18)____________________________________________________________________________________________
Name:_____________________________________________________________________________Email______________________________________________________
Address:___________________________________________________________________________Fee Enclosed $_______________ check #: _________________
City, State,Zip____________________________________________________________________ Daytime Phone __________________________________________
T-shirt size (circle one) child size 10-12/Adult Sm/Adult Med/Adult Lg/ Adult XL/Adult 2XL/no shirt
Brain Tumor Survivor: Yes No (No registration fee for brain tumor survivors)
Participant Waiver Signature (required) ______________________________________________________________________________
Guardian Signature (if participant is under18)____________________________________________________________________________________________
Mark Linder Walk for the Mind - Location: Riverplex, Peoria, IL
Saturday, September 28, 2013 Registration & Raffle opens 7:30 a.m. Program begins 9:30 a.m.
www.marklinderwalkforthemind.org
Please feel free to make copies of this registration page for additional registrations