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					               3rd Annual
   5K Run/Walk for Wellness and Recovery
                        Springfield Hospital Center
                      Rehabilitation Services Department
                    Saturday, September 22, 2012; 8:30 a.m.

             2012 DONATION CERTIFICATE
The Springfield Hospital Center greatly appreciates the generous support of community members and
businesses. Donations include:
       * cash
       * prizes
       * material support of the race
    A Gold Sponsor ($500.00 in funds or $300.00 in funds plus $200.00 in goods) will receive:
       advertisement on the participants’
       T-shirts (will receive one free T-Shirt), advertisement on participants’ bags, advertisement in the
       program and on the registration forms, a place to display advertising near the registration area,
       advertisement displayed among the runners/walkers route, and announced as a gold sponsor
       before the event and during the awards.
    A Silver Sponsor ($300.00 in funds or goods) will receive: advertisement on the participants’
       bags, advertisement in the program, a place to display advertising within the park area,
       advertisement displayed among the runners/walkers route, and announced as a silver sponsor
       before the event and during the awards.
    A Bronze Sponsor ($150.00 in funds or goods) will receive: advertisement in the program,
       advertisement displayed among the runners/walkers route, and announced as a bronze sponsor
       before the event and during the awards.

Business Name:

Contact:                                                                           Phone:

Address:

Please indicate type of donation:

          Check for $                          (made payable to Springfield Hospital Center).

          This item is tangible and will be available for display on race day.

          This item is intangible and will be represented on race day by a certificate.

Signature of Donor:                                                                Date:

Item solicited by                                                of the Springfield Hospital Center.

Value of the item donated: $                           .

                               Thank you very much for your donation!

Questions regarding the donations should be directed to Laura Smolley, email – lsmolley@dhmh.state.md.us, 410-970-
7000, ext. 3343.
Donations should be mailed to: Laura Smolley
                                Springfield Hospital Center
                                Rehabilitation Services Department
                                6655 Sykesville Road
                                Sykesville, Maryland 21784

				
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