Kentucky-Ohio - Special Olympics Kentucky

PLUNGE SCHEDULE
NON PROFIT
U.S. Postage
PAID
Louisville, KY
40222
Permit #562
2014 Polar Plunge Sponsors
Friday, January 31
4-7 p.m.
Pre-Registration
Joe’s Crab Shack; Bellevue
Saturday, February 1
9:00- On-Site Registration Opens
11:30 a.m.
Costume Contest
11:30 a.m. Plunging Begins
Coming from Out of Town?
Stay at Comfort Suites Newport, the official hotel
of the Polar Plunge. It's the closest hotel to Joe’s
Crab Shack. Call 800-4-CHOICE for reservations.
1:00 p.m. Awards Presentation
Avoid Lines on Event Day!
We have a special gift, just for those
bears who turn in funds and pick up
prizes at Pre-Registration! Turn in your
money at Pre-Registration and receive
everything you need for the Plunge.
NO line on Plunge day!
Pre-Register by coming to
Joe’s Crab Shack - Bellevue
Friday, January 31
4-7 p.m.
All participants must turn in funds and have a
signed waiver on file prior to participation.
Denise Johnson
Fox19
Jon Jon
Q102
WHY WE PLUNGE
We plunge for the
athletes. Special
Olympics is a non-profit
organization that offers
year-round athletic
training and Olympictype sport competitions
for children and adults
with intellectual
disabilities. Each year more than 4 million
athletes worldwide compete in 25 official sports.
All of the funds raised by the Polar Plunge
remain in Kentucky and Ohio to benefit local
children and adults with intellectual disabilities.
If you would like to serve as a volunteer, receive
information about getting an athlete involved
or learn more about Corporate Partnership
Opportunities, please call (502) 695-8222 in
Kentucky or (614) 239-7050 in Ohio or visit
soky.org or sooh.org.
soky.kintera.org/2014ky-ohpolarplunge
Return Service Requested
Opening Ceremony/
Special Olympics Kentucky
105 Lakeview Ct.
Frankfort, KY 40601
11 a.m.
Joe’s Crab Shack - Bellevue
Saturday, February 1
Kentucky-Ohio
PLAN.
Get your team together
and get ready to Plunge!
Moral support never hurts.
Vacation Certificate from
AAA Travel
$5,000 + Columbia Plunge Jacket
and 15 Grand Prize Entries
$2,500 - $4,999 Sherpa Plunge
or anybody who wants to Plunge together.
Blanket and
12 Grand Prize Entries
Or Plunge on your own!
Raise at least $75 per person in
donations! ($50 for Junior Plungers, age
6-18)
All funds raised will benefit Special Olympics
Kentucky and Ohio. The more you raise, the better
the prizes! Prizes other than the t-shirt and towel
are NOT cumulative and will not be available at
the Plunge.
PLUNGE!
King and Queen of the Polar Plunge
(Top fundraising male and female)
Receive a Coleman Steel Cooler
Prince and Princess of the Polar Plunge
(Top fundraising boy and girl, age 6-12)
Receive a Polar Plunge Jacket with name
Gold Medal Athlete
Receives a $50 Joe’s Crab Shack Gift Card and Plaque
Teams can be friends, family or co-workers,
PLEDGE.
Individual Awards
Team Awards
$1,500 - $2,499 Polar Plunge
Robe and 9 Grand Prize Entries
$1,000 - $1,499
Polar Plunge Hoodie
and 6 Grand Prize Entries
$500 - $999 Custom
Tervis Water Bottle and
3 Grand Prize Entries
$250-499 Polar Plunge
Towel and
1 Grand Prize Entry
$75 and up ($50 for Junior Plungers)
Polar Plunge T-shirt
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Best Costume Award
A Golden Plunger will be given for the best individual
and group costumes.
• Bring a friend. Friends don’t let
friends Plunge alone!
• Have fun. Wear a costume!
• Protect your paws with old tennis shoes or water shoes.
• Bring a robe and towel to dry your wet fur.
• Bring a change of clothes for the After Splash Bash.
Polar Cups will be presented to the largest
teams in each of these divisions:
• Corporate/Civic
• Law Enforcement
• School/University Group
• Top Fundraising Team
REGISTER
Complete this form
and bring it with you to pre-registration
or registration for the Plunge. Or get started online at:
soky.kintera.org/2014ky-ohpolarplunge
Donations
Pledge Amount
City/State/Zip_______________________________________
Phone (________)_ ________________________________
Birthdate ___________
Age ____
o
Male
o
Female
e-mail___________________________________________
o please send me e-mail updates about Special Olympics
Plunging: o
o
as an individual
o
Too Chicken to Plunge
as a SOKY athlete
o
law enforcement
with a team (circle division)
civic/corporate
school/university
Team Name________________________________________
I am unable to Plunge, but I want to donate:
o $25
o $50
o $100
o $__________
Please enclose check made payable to “Special Olympics”
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND
INDEMNITY, AND PARENTAL CONSENT AGREEMENT (“AGREEMENT”)
In consideration of participating in the Polar Plunge, I represent that I understand the nature of the
event and that I and/or my minor child am qualified, in good health, and in proper physical condition to participate. I acknowledge that if I and/or my minor child believe event conditions unsafe, I
and/or my minor child will immediately discontinue participation in the Activity.
Online Fundraising
I fully understand that the Polar Plunge event involve risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those
of others participating in the event, the conditions in which the event takes place, or the negligence
of the “releasees” named below; and that there may be other risks either not known to me or not
readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for
losses, costs, and damages I and/or my minor child incur as a result of my and/or my minor child’s
participation in the Activity.
Visit soky.kintera.org/2014ky-ohpolarplunge
to get started. You can build your own home page, recruit
a team or set an individual goal, and then easily send an
e-mail to all your friends asking them to sponsor you or
join your team.
I hereby release, discharge, and covenant not to sue Special Olympics Inc., Special Olympics Kentucky,
Inc. and Special Olympics Ohio, Inc., its respective administrators, directors, agents, officers, volunteers,
employees, other event participants, any sponsors, advertisers, and, if applicable, owners and lessors of
the premises on which the Activity takes place, (each considered one of the “RELEASEES “herein) from
all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole
or in part by the negligence of the “releasees” or otherwise, including negligent rescue operations; and I
further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my
and/or my minor child’s behalf, makes a claim against any of the Releasees, I will indemnify, save, and
hold harmless each of the releasees from any loss, liability, damage, or cost which any may incur as the
result of such claim. I am also granting my permission to Special Olympics to use my likeness, name,
voice and words in television, radio, film, newspapers, magazines and other media, and in any form,
for the purpose of advertising or communicating the purpose and activities of Special Olympics and/or
applying for fund to support those purposes and activities.
Afraid of
the Cold?
That doesn’t mean you
can’t be a part of the fun!
Just let us know that you’re Too Chicken to Plunge!
Once you raise $75 (or $50 for Junior Chickens) you’ll
get a special “Too Chicken to Plunge” T-shirt. Then as
you raise more money, you can earn all the same great
Plunge merchandise that the Polar Bears earn. Be Proud!
Be a Chicken and STILL support Special Olympics
athletes! There will even be a special award for the Top
Fundraising Chicken!
Address__________________________________________
Employer_________________________________________
I am raising funds on behalf of Special Olympics athletes. I’ll
take the Plunge and defy Old Man Winter, and you can join
me in the spirit by making a donation. Your contribution helps
support year-round sports training, competition, and programs
for children and adults with intellectual disabilities. Make
checks payable to Special Olympics. Sponsors of $25 or more will
receive a receipt.
Donor Name
Name___________________________________________
I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY
AGREEMENT, AND PARENTAL CONSENT AGREEMENT, understand that I have given up substantial rights
by signing it and have signed it freely and without any inducement or assurance of any nature and
intend it be a complete and unconditional release of all liability to the greatest extend allowed by
law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
Signature: X_______________________________________________________
Total
More info: 502-695-8222 or 614-239-7050
X_____________________________________________________________
(Parent/Guardian signature if participant is less than 18 years of age)