OLYMPIC OVAL SKATE-A-THON - Hockey Calgary

NEW THIS YEAR! ONE GRAND PRIZE WILL BE AWARDED TO THE TOP SKATER WHO COLLECTS THEMOST MONEY IN SPONSORSHIPS. ~ PRIZE TBA ~REGISTRATION FORMSKATER’S NAMEADDRESSCITYPROVINCEPOSTAL CODEPLEASE NOTE: There are limited skating times available.1.5 hour time frame per skater.LOCATION: OLYMPIC OVAL2500 University Drive NW Calgary, Alberta T2N 1N4PREFERRED SKATING TIME (please select one)You will be placed in a 1.5 hour time block12:00 pm - 1:30 pm 3:00 pm - 4:30 pm1:30 pm - 3:00 pm2011 HOCKEY MUMS FIGHT BREAST CANCEROLYMPIC OVAL SKATE-A-THONSUNDAY, MARCH 6, 2011While I am unable to attend the skate, I would liketo make a donation to the Hockey Mums FightBreast Cancer Skate in the amount of$ _____________________Please make cheques payable to:Canadian Breast Cancer Foundation -Prairies/NWT RegionWAIVER: In consideration of being permitted to participate inthe Hockey Mums Fight Breast Cancer Skate, I hereby for myself,my heirs, and personal representatives assume any and all riskswhich might be associated with the event. I further waive, release,discharge, and covenant not to sue the Calgary Hitmen HockeyClub, it’s employers, sponsors, organizers, volunteers, or any otherrepresentatives, or their successors and assigns, for any and allinjuries or damages of any kind whatsoever suffered as a result oftaking part in the event and any related activities. I also agree to theuse of any photo, film, or videotape of the event for any purpose.Your skating time will be confirmed by email or telephonebased on availability.SignatureT-SHIRT SIZE (please select one)smallmediumx-largexx-largelargeParent’s Signature (if participant is under 18)Please email this registration form to info@hitmenhockey.com or fax to 403-571-2211

2011 HOCKEY MUMS FIGHT BREAST CANCEROLYMPIC OVAL SKATE-A-THONSUNDAY, MARCH 6, 2011SPONSORSHIP PLEDGE FORMSEach participant’s pledge form must have full contact information to be included in individual fundraising total.Canadian Breast Cancer Foundation-Prairies/NWT Region#430, 1324 17 Avenue SWCalgary, Alberta T2T 5S8Telephone: 403-209-2233Fax: 403-209-2366NAME OF PARTICIPANTMAILING ADDRESSEMAIL ADDRESSCHEQUES CAN BE MADE PAYABLE TO:CANADIAN BREAST CANCER FOUNDATION - PRAIRIES/NWT REGIONPLEASE NOTE: TAX RECEIPTS ARE ISSUED ONLY FOR DONATIONS OF $20.00 OR MORETELEPHONE NO.FOR MORE INFORMATIONEmail: dfretts@hitmenhockey.comAttn: Derald Fretts1.NAME OF SPONSOR(Please Print)COMPLETE MAILINGADDRESS CITY PROVPOSTALCODETELEPHONENUMBERPLEDGEAMOUNTCASH ORCHEQUERECEIPTREQ’D2.3.4.5.6.7.8.9.10.11.12.13.14.15.PLEASE BRING THISFORM ALONG WITHYOUR PLEDGES ONMARCH 6, 2011THANK YOU for your kind donation. Your support is greatly appreciated.* T-SHIRT & MARCH 13th GAME TICKET PROVIDED TOREGISTERED SKATERS WHILE SUPPLIES LAST ** (minimum $20 per person sponsorship or donation)CASHTOTALCHEQUETOTALDONATIONTOTALPLEASE PHOTOCOPY AND ATTACH ADDITIONAL SHEETS IF NECESSARY