Sponsor SHEET

#
	Name	Amount 	
1
			
2
			
3
			
4
			
5
			
6
			
7
			
8
			
9
			
10
Total			

If you have more sponsors, please use an additional sheet.

WALK FOR INDEPENDENCE

Saturday, September 22, 2018
Loose Park Pavilion

ABOUT THE WALK FOR INDEPENDENCE

You can help by obtaining sponsors and joining us for our 2018 walk on Saturday, September 22.

Registration begins at 9:00 a.m. at the Loose Park Pavilion at 5200 Wornall Road. The Park entrance is between 51st and 55th Streets. The registration fee is $10.
 
You may turn in your sponsor sheet, donations, and registration  fee in advance or at registration on the day of the walk.  Checks should be made payable to: NFB - Kansas City. 
To qualify for prizes, money should be turned in by October 20. 

The walk will begin at 10:30 am (rain or shine) and ends at 
12:30 pm. You choose how far you walk! The perimeter around the park is equivalent to one mile.

To obtain more information about this event or the National Federation of the Blind, you may contact us at 816-505-5520 

The National Federation of the Blind knows that blindness is not the characteristic that defines you or your future. Every day we raise the expectations of blind people because low expectations create obstacles between blind people and our dreams. You can live the life you want; Blindness is not what holds you back.

REGISTRATION

Name:____________________________________

Address:__________________________________

_________________________________________

Phone:____________________________________

Emergency Contact Information:

Name:___________________________________

Phone:__________________________________

WAIVER

I hereby waive all claims against the National Federation of the Blind, State affiliates, chapters, and any personnel for any injury I might suffer in this event. 

Signature:_________________________________

If the walker is under the age of 18, signature of parent or guardian is required below.

Signature:_______________________________