Walk-a-thon fundraiser pledge form

							                          Most Blessed Sacrament Catholic School
                                   2012 Dance-A-Thon!
Student Name: _____________________________ Grade:________________________________
Dear Sponsor,
I will be participating in the MBS Dance-A-Thon on Friday, October 26th, 2012. All proceeds will help fund the
Home and School Association’s support of the school. Our goal is to raise $25,000 this year and your donation
will help us get there. Please make checks payable to MBSCS.
Thank you!

Name of Sponsor                                                                               Pledge

      1

      2

      3

      4

      5

      6

      7

      8

      9

    10

    11

    12

    13

    14

    15

    16

    17

    18

    19

    20


Total Sponsorship Amount: $___________.
Students:
Please return this form and all donations (cash and/or checks) on or before, Wednesday, October 10th, 2012.
REMEMBER, you must raise a minimum of $50 to receive a T-shirt. Coins will NOT be accepted.

Please Circle T-Shirt Size:   YS     YM     YL     Adult S        M       L      XL     XXL