Buddy Walk 2011 Pledge Form

To register, print and complete this form. Contributions may be turned in the day of the walk or mailed to:

Columbus Area Down Syndrome Support Group
P.O. Box 1732
Columbus, Indiana 47202-1732

Name _______________________________________________

Address _____________________________________________

City ______________________   State ______   Zip __________

Daytime Phone ___________   E-Mail Address _______________

Total Raised  $____    

Sponsor Name	Amount

 

Make checks payable to: Arc Buddy Walk 2011