Scottish Rite - Valley of Peoria

Masonic Learning Center Walk


32º Masonic Learning Center Walk

United States Presidents have called it “THE WORLDS MOST BEAUITFIL DRIVE”. Now
you can join us and see for yourself as we walk Grand View Drive. The walk will overlook the ILLINOIS RIVER VALLEY and all of it’s beautiful fall colors. Raising money for the 32° Masonic Learning Center for Children with DYSLEXIA on Saturday morning October 17, 2009. Registration starts at 8 am and the walk starts at 9am. The walk starts at the Peoria Heights Water Tower Park goes to Peoria Country Club and back. Please pre-register by October 7, 2009 to guarantee your t-shirt size. (Entry blank and pledge forms below)

Registration


I plan to participate in the WALK. Enclosed is my

registration fee of $25 for adults, $10 for children

under 12. I cannot attend, but enclosed is my

donation of $ ________
I would like to volunteer the day of the Walk.

Please contact me at the phone/email below.
_______________________________________
T-Shirt Size ----- Adult or Youth _____________
• Please make check payable to CLC Dyslexia Walk.
Mail your registration form to: Children's Learning

Center Walk for Dyslexia,

Attn: John Sutherland,

214 W. Northridge Lane,
Peoria, IL 61614.

Name _____________________________________
Address __________________________________________
Home /Work/Cell Phone
__________________________________________
Email______________________________________

 

Emergency Contact and Phone Number ____________________________________
Participant Liability Agreement:
Please enter me in the "Walk to Help Children with Dyslexia". I, on behalf of myself, my heirs, executors, and administrators hereby release the 32· Masonic Learning Centers for Children, Inc. from any all claims, damages, and rights of action I may have, present or future that may arise out of, or be incident to my participation in the Walk event. In addition, I grant
permission for the use of my name and/or picture in any photograph, film or videotape of the event for any purpose.
Signature ___________________________
(parent or guardian if under 18 years of age)
This agreement must be signed for the registration to be valid.

PLEDGE FORM


Walkers Name________________________
My Fundraising Goal is: $_______
The 32° Masonic Learning Center is a 501(c)(3) nonprofit organization and pledges are tax deductible.
Make checks payable to:

CLC Dyslexia Walk
Pledges will be collected when you check in.
Sponsors (Please Print)
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
Name_______________________________
Phone_________________Amt:__________
TOTAL COLLECTED $_______________