pledge sheet - Mother`s Day Walk

RESEARCH SAVES LIVES
INCENTIVES
HOW TO ENTER
The Breast Cancer Society of Canada’s mission is to save
lives through breast cancer research.
All Participants will receive
BCSC Pink Scarf and cleo Voucher for $10 off
every $50 purchase with submission of pledges.
To become a Mother’s Day walk participant simply
follow the steps below.
Supporting patient focused research is making a
significant impact in the lives of people going through
and surviving breast cancer. Our vision is an end to
breast cancer.
HISTORY OF THE WALK
In 1991 Pam Greenaway-Kohlmeier’s family and friends
walked together in her honour. From these passionate
beginnings, the Mother’s Day Walk was the very first
event held by the Breast Cancer Society of Canada.
Pam continues to be our inspiration!
Help us make 2015 our best year EVER
Join the Breast Cancer Society of Canada and cleo for
the 2015 Mother’s Day Walk. Discover why thousands
of Canadians have made this event a family tradition!
Walk or run 5k at one of the 4 beautiful outdoor locations
or “Take a short walk to end breast cancer in the long run™”
at one of over 70 cleo store location across Canada.
Every step takes us closer to a cure
$100 in pledges
Receive BCSC Keychain
$250 in pledges
Receive a $25 cleo Gift Card
and BCSC Keychain
$500 in pledges
Receive a $50 cleo Gift Card
and BCSC Keychain
$750 in pledges
Receive a $75 cleo Gift Card
and BCSC Keychain
$1,000 in pledges
Receive a $100 cleo Gift Card
and BCSC Keychain
$1,500 in pledges
Receive a $155 cleo Gift Card
and BCSC Keychain
$2,000 in pledges
Receive a $200 cleo Gift Card
and BCSC Keychain
Incentives are based on individual fundraising
achievements and will not be issued on team totals.
Verification is required.
420 East Street N.
Sarnia, Ontario N7T 6Y5
1-800-567-8767
www.mothersdaywalk.ca
Incentive items not available on walk day will
be mailed by August 31, 2015. Incentive items no
longer available will be substituted with
items of equal value.
Step One:
Register yourself online at www.mothersdaywalk.ca to
collect online donations! Recruit friends, family and
co-workers to join in the fun.
Step Two:
Please complete the form on the reverse side of this
brochure with your full name, mailing address, phone
number and indicate the cleo walk location of your
choice.
Using the pledge sheet give the first donation and ask
donors to follow your lead.
Step Three:
Bring your pledge sheet and donations to the cleo
store or walk location on walk day.
FOR YOUR CONVENIENCE PLEASE NOTE:
cleo Mall Walks accept cash, debit and credit cards
only.
Park locations accept cash and cheques made payable
to Breast Cancer Society of Canada.
BCSC automatically receives all online donations.
Verification of online pledges is required to ensure
qualifications of incentives. Please print personal
fundraising page and attach to pledge sheet.
WALK DATES
Sunday, May 3 2015
All cleo Mall Walks
Edmonton, AB Emily Murphy Park
Sunday May 10 2015
Sarnia, ON Canatara Park
London, ON Gibbons Park
Mississauga, ON Streetsville Memorial Park
Join us for our Annual
Mother’s Day Celebration
May 2015
In support of the
Breast Cancer Society of Canada
Take A Short Walk To End Breast Cancer In The Long Run™
Together we can make a difference
Ask a cleo associate for further details or contact
the Breast Cancer Society of Canada.
1-800-567-8767
www.mothersdaywalk.ca
All pledges are due no later than the day of the walk. For your convenience, cleo store
location accept cash, debit and credit cards (sorry no cheques). Park locations accept
cash and cheques made payable to Breast Cancer Society of Canada. Tax receipts will
be issued for amounts of $20 and over providing all necessary information is provided.
Charitable Registration BN#137969861RR0001
The Breast Cancer Society of Canada and cleo thank you for your support
WALK DETAILS
$50.00
Donation
Postal Code
No Incentive Gift Required
cleo Gift Card Received
cleo Voucher Received
BCSC Keychain Received
MOTHER’S DAY WALK RECEIPT
www.mothersdaywalk.ca
cleo Gift Card Received
cleo Voucher Received
BCSC Keychain Received
BCSC Pink Scarf Received
Verified By / Store No.
GRAND TOTAL
Walk Location (ie: Park, Mall)
Walk (city)
Name
Please tear off and give to participant.
)
BCSC Pink Scarf Received
Verified By / Store No.
GRAND TOTAL
Pledge Sheet Total
Verified Online Donation Total
123 Main Street, Box 20, City, Province, N2V 1B1
Street Address/Unit#/City/Province/Postal Code
Together we are making a difference!
Signature:
(
Phone
PRINT & ATTACH ONLINE DONATION DETAILS
Province
In signing this release, I acknowledge that I understand the intent thereof, and I hereby agree and
absolve and hold harmless the Breast Cancer Society of Canada cleo, mall management, companies,
sponsors, co-operating events and any other parties connected with this event in any way, singly
or collectively, from and against any blame and liability for an injury, misadventure, harm, loss,
inconvenience or damage hereby suffered or sustained as a result of participation in the 2015 Breast
Cancer Society of Canada and cleo Mother’s Day Walk or any activities associated therewith. I hereby
consent to and permit emergency treatment in the event of injury or illness. I also give full permission
for use of my name and/or photograph in connection with this event. Furthermore, I give permission
to allow the Breast Cancer Society of Canada and/or cleo to send/email me information periodically.
Waiver
Jane Doe
DONOR (First/Last Name)
Walk Location
Email Address
City
Address
Name of Participant
Mother’s Day Walk 2015 Pledge Sheet