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2005 IUPUI Dance Marathon Information Packet

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2005 IUPUI Dance Marathon Information Packet Powered By Docstoc
					IUPUI Student Foundation
           Presents:

           Jagathon
   (IUPUI Dance Marathon)




  “Let’s make kids feel better!”


 Participant Packet
       October 21, 2011
     IUPUI Campus Center

                                   1
Dear IUPUI Student,

What do you know about Riley Hospital for Children? Do you know that it is part of our
campus? Do you know that it serves the sickest children in Indiana and surrounding states?
Do you know that Riley never turns away any patient, regardless of their inability to pay?
Miracles happen every day there, allowing children a chance to live lives that wouldn’t be
possible without the help of caring people in Indiana. Caring people like you!

The IUPUI Student Foundation is planning a Jagathon (IUPUI Dance Marathon) for our
campus to raise money for Riley. These funds will provide much needed help to Riley to serve
the kids. Over the last seven years Dance Marathons have become one of the largest
student-run philanthropic events on college campuses across the country and give students an
opportunity to build leadership skills and utilize their talents in a team environment.

Participants in the IUPUI Jagathon will raise money by securing donations and pledges in
advance, and those funds will stay local to benefit Riley Hospital for Children. Jagathon is
music, food, entertainment, excitement, and fun! Once you get to the Jagathon,    you won’t
have to dance a step if you don’t want to, but we will ask you to stay on your feet for the
entire 6 hours. You’ll be having so much fun listening to the bands, playing games, eating, and
hanging out with Riley families and your friends that you won’t even realize what time it is!

Since this summer, members of the IUPUI Student Foundation and Jagathon Executive
Council have been working hard to plan a fun and successful Jagathon. The IUPUI Jagathon
will last 6 hours and has a goal of 100 participants who will each raise $100 dollars total ($15
registration fee and $85 donation), to be a part of the event. Your donation can be collected
from various donors such as family, friends, co-workers and classmates. We know that college
students don’t have a lot of extra cash, but you do have your health and time to give to this
cause. It’s easy to ask 20 people to donate $5 for this great cause!

Please help make this event a success for all participants, and most importantly for the
children at Riley Hospital.



For the Kids,
IUPUI Jagathon (Dance Marathon) Executive Council




                                                                                                  2
2011 Jagathon Information Packet
Jagathon is an all night party to benefit Riley Hospital for Children! It is an
opportunity for IUPUI students to make a difference for families in Indiana.
Each participant raises at least $100 and then celebrates with the families
and children that they’re helping by spending 6 hours on their feet having fun
and enjoying live bands, free food, and plenty of fun activities, all at the
Campus Center. The Jagathon Executive Council will help all participants with
ideas and plans to raise the $100 requested to participate.

While many schools still use the name “Dance Marathon,” the IUPUI Student
Foundation has decided to refer to IUPUI’s Dance Marathon as the IUPUI
Jagathon to dispel the misconception that the event requires dancing. The
name “Dance Marathon” refers to the Dance Marathons that took place in
the 1950s; there are now Dance Marathons on nearly 100 college campuses
around the country, raising funds for their local children’s hospital through
the Children’s Miracle Network.




      Michael Holcombe              Sophie Collier
      Riley Kid                     Riley Kid




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How to register for Jagathon:

1. Fill out the entire registration from, including the medical release form.



2. Attach the $15 registration fee (advance donation) to the last page and
turn it in to the IUPUI Student Foundation in the Campus and Community
Life Office in the Campus Center.



3. Ask everyone you know to donate on your behalf for Riley Hospital for
Children towards your total goal of $100, including the registration fee.
Raise more if you can!



4. Collect your donations and put them in an envelope. Please bring these with
you on Friday, October 21st.



5. Watch your inbox for updates about theme hours, special prizes, and
incentives!



6. Arrive at the IUPUI Campus Center on Friday, October 21st. Registration
begins at 5:00 p.m. and the Jagathon will kick-off at 6 p.m.



7. Encourage your IUPUI classmates and friends to participate!




                                                                                4
Helpful Tips: FUNDRAISING

 Familiarizeyourself with the purpose of the marathon and be prepared to explain the idea
thoroughly to a possible donor.

 Be    enthusiastic with your presentation.

 Request    to speak to the manager of your favorite local stores.

 Write   letters or just ask family, friends, doctors, dentists, teachers and classmates, or just
fill out the donor mailing list and we will mail the letters for you!

 Checks  should be made payable to Supporting Riley Children, Inc., memo IUPUI Jagathon
as well as the participant’s name.

 Start    right away!

 Have    more questions? Ask members of the IUPUI Student Foundation:
                           Advisor: Andrea Anderson aeickhof@iupui.edu
                             President: Cora Griffin cjgriffi@iupui.edu
                         Jagathon Chair: Taylor Rhodes rhodta@gmail.com


Helpful Tips: HOW TO PREPARE AND WHAT TO BRING

        Be sure to get a good night’s sleep before the marathon.
        Bring at least two pairs (you might consider slippers!) of shoes so you can avoid getting
         sore feet.
        Any personal hygiene products you might need – toothbrush, deodorant, etc.
        A couple of shirts to wear under your Jagathon t-shirt.
        A camera for all of those Kodak moments!
        Mailing addresses from donors.
        Theme Hour Costumes.
        A GREAT ATTITUDE!



REMEMBER! Watch your inbox for updates on Jagathon Theme Hours, special prizes, and
                             fundraising incentives!

                                                                                                     5
Donor Mailing List
Please fill out the following form with the names and e-mail addresses of people we can
contact for donations.
Donor Name                                       Donor Address




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Dear Friends and Family,

On October 21, 2011, IUPUI Student Foundation will host the 11th Annual IUPUI Jagathon
(Dance Marathon) to benefit Riley Hospital for Children. Dance Marathon is a nation-wide
phenomenon on college campuses that give college students the opportunity to raise money for
local children’s charities. I want to do everything possible to help the kids!

This year our goal is to gather over 100 IUPUI students to participate in this event; dancing,
playing games, talking, and eating for 6 hours, all in order to raise over $20,000 for Riley
Hospital for Children here on our campus in Indianapolis. Our organization raises money
through pledges from family and friends and from corporate donations.

Our Slogan for this year, “Let’s Make Kids Feel Better” truly demonstrates the spirit of this
event. I am proud to be a part of the IUPUI Jagathon and would appreciate any support you
are able to offer. In order to even participate each student must raise at least $100 and I
need your help. I sincerely appreciate any donation you are able to offer. If I am able to
raise $10 from 10 different people, then I will be able to participate!

Checks can be made payable to Supporting Riley Children, Inc., and sent to my address. Riley
Hospital, as a part of the Children’s Miracle Network, treats all children in Indiana who need
their services, regardless of their ability to pay. Donations to the IUPUI Jagathon will
provide funds for these kids and their families that need treatment the most.

Please feel free to contact me if you have any questions regarding the IUPUI Jagathon or
Riley Hospital for Children. Thank you for your time and consideration.



For the Kids,




                                                                                                 7
Jagathon Registration Information
Organization (please choose one, if any): ________________________________

Name: ______________________________________________________
      Last                    First


E-mail: _______________________________ Phone: _______________________


Address: __________________________________

         __________________________________

Were you ever personally affected by Riley Children’s Hospital? ____Yes ____ No
Please explain the experience:


Release Form:
In consideration for the opportunity to participate in this event, which is sponsored by the IUPUI
Student Foundation, I hereby release their representatives from any and all liability for injuries or
damages that I may sustain as a result of my participation in the IUPUI Jagathon. I also realize that
any medical expenses incurred as a result of my participation in this event will be my sole
responsibility and that I am participating at my own risk. In addition, I realize that the IUPUI Student
Foundation is not responsible for any lost, damaged, or stolen items, and will not refund any
payments to the event. I understand that I am participating at my own risk and I release the IU
Foundation, the
IUPUI Student Foundation, the Trustees of Indiana University and their representatives from all
responsibility.

Participant Name: _________________________________________________

Participant Signature: ______________________________________________

I want to know more about the IUPUI Student Foundation:
   Yes
   No


Please complete pages 8-11 and return (along with the Medical Registration Form) to the
Campus & Community Life office on the 3rd floor of the Campus Center.




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Medical Registration Form
Please fill in ALL blanks.

Name: ____________________________ Age:_________________________

Student ID#: _______________________ Sex: M          F

Address: ____________________________________________________________________

Phone: ______________________ Alt Phone: _____________________

Medical History: Check any that applies to you. If you take any medication for it, please check the
blank after the condition.

Are you planning to bring any prescription medications to the Marathon? Yes No
Please mark any conditions you have, and explain any medications needed.
     Asthma
     Other breathing problems: Please describe ______________________________________
     Contact Lenses
     Diabetic
     Are you insulin dependent? Yes No
     Epilepsy/Seizures
     Fracture or dislocation (recent)
     Describe
     Headaches (frequent)
     Heart Problems
     Describe
     High Blood Pressure
     Surgery (recent), describe: ______________________________
     Other: ______________________________________________
Allergies Please check all that apply
     Insect bites/stings Medication required? Yes    No
     Penicillin
     Aspirin
     Tylenol
     Foods: __________________________________
     Unknown if allergic to anything
     Other: (describe) __________________________
     None


Emergency Contact List someone you would want us to contact in case of emergency.

Name: _____________________________________________

Phone: ___________________________

Address: __________________________

__________________________________

Relationship: _______________________
                                                                                                      9
RILEY CHILDREN’S FOUNDATION
ACKNOWLEDGMENT, WAIVER, RELEASE OF LIABILITY, AND INDEMNIFICATION
In exchange for my being allowed to volunteer (as a "Volunteer") for or participate (as a "Participant") in a dance
marathon (the "Event"), a program conducted by Indiana University Purdue University at Indianapolis (IUPUI)
Student Foundation and sponsored by Indiana University Foundation for the benefit of James Whitcomb Riley
Memorial Association, d/b/a Riley Children's Foundation (the "Foundation"), and James Whitcomb Riley Hospital
for Children (the "Hospital"), I, _______________________________, of
______________________________________________________________________(home address), and if I am
not yet 18 years old, my parent(s) or legal guardian(s) (individually and collectively referred to below in the first
person singular) agree to be bound by each of the following:
Description of Event. The Event is a marathon in which the participants stay on their feet or dance continually
and with only limited breaks. It will occur on October 21, 2011 on the IUPUI campus. It is an event that tests a
person's physical, mental, and emotional limits in the extreme.
Not a Foundation-Sponsored Activity. I understand and acknowledge that the Event is not sponsored, conducted,
supervised, or monitored by the Foundation, the Hospital, Indiana University, or Clarian Health Partners, Inc.
(collectively, the "Corporations"), and that the Foundation and the Hospital are merely the beneficiaries of a
portion of the proceeds from the Event. I further understand and acknowledge that none of the Corporations will,
nor does any of them have the obligation to, make available any medical equipment or personnel at or in
connection with the Event for the benefit of Volunteers for or Participants in the Event.
Voluntary Involvement. I understand and confirm that my involvement in the Event as a Volunteer or a Participant
is voluntary.
Parental Approval. I have informed my parents of my intention to participate in the Event, and I have obtained
their approval of my participation in the Event.
Identification of Risks. I understand that my involvement in the Event as a Volunteer and/or Participant may carry
risk of injury and loss, both to person and to property. I also understand that such risk of injury may include the
possibility of permanent disability and death. I understand that this Acknowledgment, Waiver, Release of Liability,
and Indemnification is intended to address all of the risks of any kind associated with my involvement as a
Volunteer and/or a Participant in any aspect of the Event, including, particularly, such risks created by actions,
inactions, carelessness, or negligence on the part of the Corporations or any of their directors, trustees officers,
employees, agents, volunteers, successors, or assigns.
Assumption of Risks. I assume all risks, known and unknown, foreseeable and unforeseeable, in any way
connected with my involvement in the Event as a Volunteer and/or a Participant. I accept personal responsibility
for any liability, injury, loss, or damage in any way connected with my involvement in the Event as a Volunteer
and/or a Participant.
Release and Waiver. I release the Corporations and their directors, trustees, officers, employees, agents,
volunteers, successors, and assigns from any and all liability for and waive any and all claims for injury, loss,
damage, or expense, including attorneys' fees, in any way connected with my involvement in the Event as a
Volunteer and/or a Participant (a "Claim"), whether or not caused in whole or in part by the negligence or other
misconduct of any of the Corporations, any of the individuals mentioned above, or any other Volunteer or
Participant in the Event.
Indemnification. I agree to indemnify and to hold harmless (in other words, to reimburse and to be responsible
for) the Corporations and their directors, trustees, officers, employees, agents, volunteers, successors, and assigns
from all Claims (including the cost of defending any Claim I might make, or that might be made on my behalf, that
is released or waived by this instrument) in any way connected with or arising out of my involvement in the Event
as a Volunteer and/or a Participant (including Claims relating to my actions while under the influence of alcohol
or any other substance served or made available in connection with the Event), whether or not caused in whole or
in part by the negligence or other misconduct of any of the Corporations, any of the individuals mentioned above,
or any other Volunteer or Participant in the Event.
Binding Effect. This instrument shall be binding upon my relatives, personal representatives, heirs, beneficiaries,
next of kin, or assigns and shall inure to the benefit of the Corporations and their successors and assigns.
Severability. If any term or provision of this instrument or the application thereof to any persons or circumstances
shall to any extent or for any reason be invalid or unenforceable, the remainder of this instrument and the
application of such term or provision to persons or circumstances other than those as to which it is held invalid or
unenforceable shall not be affected thereby, and each term and provision of the instrument shall be valid and

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enforced to the fullest extent permitted by law.
Applicable Law. Because each of the Corporations is located in the State of Indiana and the Event is being held in
the State of Indiana, and in order to provide certainty in the law to be applied to the construction of this
instrument, this instrument shall be governed, construed, and enforced in accordance with the law of the State of
Indiana.

THIS IS AN ACKNOWLEDGMENT, WAIVER, RELEASE OF LIABILITY, AND INDEMNIFICATION.
I HAVE READ THIS ACKNOWLEDGMENT, WAIVER, RELEASE OF LIABILITY, AND
INDEMNIFICATION. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT. I AM SIGNING THIS ACKNOWLEDGMENT, WAIVER, RELEASE OF LIABILITY,
AND INDEMNIFICATION VOLUNTARILY.

____________________________________________________________________ __________________
Printed Name            Signature             Date

If the person involved in the Event as a Volunteer and/or a Participant is not yet 18 years old, both parents or the
legal guardian(s) also must sign:
In exchange for my/our child or ward having the opportunity to be involved in the Event as a Volunteer and/or a
Participant, and as the parents or legal guardian(s) of the above-named individual, I/we verify that I/we fully
understand, agree to, and accept all provisions of this Acknowledgment, Waiver, Release of Liability, and
Indemnification.


____________________________ ____________________________ __________________
Printed Name (Parent or Legal Guardian)  Signature       Date


____________________________ ____________________________ __________________
Printed Name (Parent or Legal Guardian)  Signature       Date




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