How to HOW MUCH CAN Participate: YOU RAISE???

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How to
Participate:
® Register by completing this form.
Youth For Hospice
Dance-A-Thon
Friday, April 5, 2013
(snow date: Saturday, April 6)
7:30 PM - 11:00 PM
(Doors close at 9 pm)
At
Albertus Magnus
High School
798 Route 304, Bardonia, NY
Open to all
high school students!
Complimentary refreshments
will be provided by
our sponsors.
Proceeds benefit
United Hospice of Rockland
Pre-registration is strongly encouraged;
Walk-ins are welcome as space allows.
® Raise money by asking friends,
family and neighbors to sponsor
your participation.
® Dance until you drop!
® Earn community service hours
by attending!
® No outside beverages please.
We will provide complimentary
food and drinks.
® Minimum $25 in sponsorships
requested for participation.
® Raise $100 or more to be entered
in Grand Prize drawing. Great
prices for highest fundraisers!
® Register early to receive a free
Danceathon T-Shirt. (T-Shirts
guaranteed only for pre-registrants).
® Send in your completed form and
sponsorship list to address on back.
HOW MUCH CAN
YOU RAISE???
We request a $25 donation as your entrance
fee. We hope you’ll raise more! Ask your
friends and neighbors. Call your grandparents. Send a text to all your relatives! We are
trying to break last year’s record, but we need
your help...
Registration Form:
(Please Print Clearly)
Name:___________________________
School___________________________
Grade___________
Graduation Year_________________
Email___________________________
Cell Number ____________________
Address_________________________
_________________________________
City_____________________________
Sponsor’s Name
Amt.
1._______________________$_______
2._______________________$_______
3._______________________$_______
4._______________________$_______
5._______________________$_______
6._______________________$_______
7._______________________$_______
Total Enclosed
$_____*
*Raise $100 to be entered into prize drawing!
UHR Dance-a-thon_Layout 1 12/18/12 2:49 PM Page 2
Youth
for Hospice
Dance
Dance
Dance
OUR MISSION:
United Hospice of Rockland provides
care, hope, comfort, and improved
quality of life to individuals and their
families facing serious illness. We
offer compassionate support to members of our community who have experienced the loss of a loved one.
Send in your completed registration
form with payment by March 15th to:
11 Stokum Lane
New City, NY 10956
Lisa Denburg, UHR
11 Stokum Lane
New City, NY 10956
Call Lisa at 845-634-4974 for more
info or email
ldenburg@hospiceofrockland.org
Friday, April 5, 2013
7:30 - 11 pm
Albertus Magnus
High School