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1 st Teen Pregnancy Prevention Walk Educate – Develop - Empower

M A D F. 1 st Teen Pregnancy Prevention Walk Educate – Develop - Empower. RAIN or SHINE!!! Making A Difference Foundation, Inc. (MADF) Invites you to walk, support & bring awareness to our Teen Pregnancy Prevention Leadership Program (TPPLP). Date: Saturday, November 6, 2010. Time:

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1 st Teen Pregnancy Prevention Walk Educate – Develop - Empower

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  1. M A D F 1st Teen Pregnancy Prevention WalkEducate – Develop - Empower RAIN or SHINE!!! Making A Difference Foundation, Inc. (MADF) Invites you to walk, support & bring awareness to our Teen Pregnancy Prevention Leadership Program (TPPLP). Date: Saturday, November 6, 2010 Time: 11:00 am Registration 12:00 am Youth Check-in (17 & under) 12:30 am Adult Check-in All Walkers Welcome Walk Location: Edgewood Park New Haven, CT 06511 Donation: $20 Registration prior to 10/30/10 $10 Youth – pre reg only $25/$15 After 10/30/10 Entry fees non-refundable Name:____________________________ Address:__________________________ _________________________________ Phone:___________________________ E-mail: ___________________________ Age: _____________________________ T-Shirt Size: M L XL (Circle Size) Help us Walk-out Teen Pregnancy Mail form(s) & donation(s) to: Making A Difference Foundation, Inc C/o Yvonne McCoy P.O. Box 185308 Hamden, CT 06518 More Info Contact:: Yvonne McCoy (203)848-0551 madf98yam@yahoo.com Waiver: In consideration of this entry being accepted. I do for myself, or any person or concern who may, on my behalf, hereby hold harmless and release Making A Difference Foundation, Inc., all sponsors and volunteers from any and all claims for personal injury, damages arising our of, or connected with, my participation in this event. I attest and verify that I have knowledge of the risks involved in participating in any of the walk and that I am physically fit to participate. ______________________________________________ ____________________________________________ Signature Date Signature of parent/guardian if under 18 of age Date

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