INDOOR  MARATHON  in  support  of                     CHILDREN'S  CENTRE  FOUNDATION   THUNDER  BAY PLEDGE  FORM PARTICIPANT  NAME  (TEAM  NAME)  ______________________________________________ ADDRESS___________________________________________________________________ PHONE  NUMBER_____________________________________________________________   FIRST  &  LAST  NAME  

MAILING  ADDRESS

EMAIL  ADDRESS

PLEDGE   AMOUNT

100.00. 100.00. 100.00. 100.00. 100.00. 100.00. 100.00.

TOTAL  AMOUNT  COLLECTED

100.00. 100.00. 100.00. $

Credit  Donations  can  be  received  online  at  https://www.canadahelps.org/dn/5450 Please  return  to  the  Children's  Centre  Thunder  Bay  283  Lisgar  Street,  Thunder  Bay  ON  P7B  6G6

CASH/   CHEQUE

PAID