Maggie Bersch Memorial Fund - Christ King School

HOLD HARMLESS/INDEMNITY AGREEMENTPARISH: CHRIST KING PARISHADULT ACTIVITY PARTICIPANT(S) (18 and older):___________________________________________________________________________________________DATE OF ACTIVITY: September 6, 2012TYPE OF ACTIVITY: MAGGIE’smile RUN/WALKThe above named activity participant(s) and other family participantslisted on the reverse side agree to defend, protect, indemnifyand hold harmless the above named PARISH and the Archdioceseof Milwaukee against and from all claims arising from thenegligence or fault of the above named activity participant(s) orany of their agents, family members, officers, volunteers, helpers,partners, organizational members or associates which arise out ofthe above named activity at the above named PARISH.Additionally, the above named activity participant(s) agree toprotect, defend, hold harmless and fully indemnify the abovenamed PARISH and the Archdiocese of Milwaukee for any claimor cause of action whatsoever arising out of the above mentionedactivity which takes place during the above identified date ofactivity that is brought against the PARISH and/or the Archdioceseof Milwaukee by the above named activity participant(s) ortheir family members whether such claim arises from the allegednegligence of the PARISH, its employees or agents or activityparticipant(s) or the facility user’s negligence.I have read and understand the hold harmless/indemnity agreementabove. I acknowledge this document governs my rights andlimits my potential remedies and I nevertheless sign it voluntarilyand knowingly.SIGNED BY:__________________________________(Adult #1)(Date)__________________________________(Adult #2)(Date)_______________________________________Parent/Guardian Signature(Date)(required for minors to participate)This agreement must be signed by each participatingadult and by a parent for minors to participate.For participants’ safety, no pets, skates, skateboards or bicyclesallowed for this event.Please return your registration to:MAGGIE’smile c/o Lisa2524 N. 90th StreetWauwatosa, WI 53226(414) 453-3827Don’t miss thePRIZE WHEELEvery Spin Wins!KidsWHO WAS MAGGIE?Margaret Louise “Maggie” Bersch courageously battled leukemiafor five years before she succumbed to complications in 2004.She loved soccer, school, her friends and her family. Maggiealways found a way to smile through radiation and chemotherapy,and often consoled friends and family as they worried about her.Maggie was a third grader with the Christ King School Class of2011 when she passed away. With her death, she left a hole inthe hearts of our community. At MAGGIE’smile, we celebratethe difference one girl made in the lives of so many.Maggie made a difference.S U P P O R T E D B Y8th Grade Marian Troop #1418Boy Scout Troop #117MAGGIE’smile CommitteeThis event would not be possible without thegoodwill and countless hours put in by themany, many volunteers.A heartfelt thank you to all.S P E C I A L T H A N K SRev. Msgr. T. George Gajdos and theChrist King Parish and Staff7th AnnualFun Run & WalkSEPTEMBER 6, 20125:00pmChrist King Parish91st & Center StreetsBenefitting theMaggie Bersch Memorial FundatChildren’s Hospital of Wisconsin

Cut Here September 6, 2012(Rain or Shine)Time5:00 pm Check-inE V E N T D E T A I L S5:45 pm Warm-up and Stretch6:00 pm Balloon Release; Run Begins, Walkers FollowSaz’s BBQ Dinner, MAGGIE’smile Band,Party & Raffle Follow the RunREGISTRATIONRegistration due by Tuesday, August 28, 2012We apologize that we can not accommodate on-siteregistration nor unregistered guests .Family Name _____________________________Address _________________________________City _________________State ____ Zip _______Bring the family and join the Christ KingParish community for a one-(s)mile fun run.Afterwards enjoy the BBQ dinner, the“MAGGIE’smile Band” and the Rafflewhile supporting the MAGGIE BERSCHMEMORIAL FUND at Children’s Hospital ofWisconsin.Proceeds from the evening are used to buyelectronics, toys, games and other items tohelp make hospital visits easier for the kids.Hang out with your friends, have some fun,and feel good even after you go homeknowing you’ve made a difference in thelives of hospitalized children.LocationCheck-in will take place at Christ King Schoolat 91st & Center. The Run/Walk will occur on thestreets and sidewalks of the surrounding neighborhood.CelebrationAfter the run, stay for the party!Entertainment by our own MAGGIE’smile Band.Dinner from 6:00 to 7:15 pm by Saz’s State House.Phone ____________ Email __________________Family Member Participants:Adults (18 & older):# 1 ___________________________________# 2 ___________________________________Children:# 1 ___________________________________# 2 ___________________________________# 3 ___________________________________# 4 ___________________________________# 5___________________________________Food Order: (One choice per person)! Raffle !Cool Prizes—but you must enter to win!So, bring some spending money.FIRST 250 FAMILIES WILL RECEIVE AMAGGIE’smile 6-Pack CoolerandFIRST 350 KIDS WILL RECEIVE AMAGGIE’smile Sport BagParticipantsOnly pre-registered entrants may participate. Pleasecomplete both sides of the form on the next page, cutit off, and return with payment by 8/28/12 to:MAGGIE’smile c/o Lisa2524 N. 90th Street, Wauwatosa, WI 53226(414) 453-3827Keep Maggie’s Memory Alive!#____BBQ #____Hot Dogs #____Veggie BurgerEntry FeesOn or before 8/28 # ___ x $10.00 = $ ____After 8/28 # ___ x $15.00 = $ ____Amount Enclosed$ _____(Make Check payable to: Christ King Parish)********************************************************************* I would like to make a tax deductiblecontribution to the Maggie BerschMemorial Fund in the amount of$______(Make Separate Check payable to: Maggie Bersch Memorial Fund)Please read and sign the hold harmless/indemnityagreement on the reverse side of this page.