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Trot to Clot Walk Participant Information

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					                                        Trot to Clot Walk
                                      Participant Information
                          Thank you for participating in the Hemophilia of Georgia Trot to Clot Walk on
                          Saturday June 12, 2010 at East Cobb Park in Marietta, Georgia. This fun,
family-centered walk will raise money to fund programs and activities for people who have hemophilia,
von Willebrand Disease, and other inherited bleeding disorders. These disorders are very rare, life-
long, and require extremely expensive medication that must be injected into a vein. Our goal is to
raise $25,000 through the Trot to Clot Walk.

The information on the following pages should be helpful to you as you prepare for the walk.

Registration Fees and Individual Fundraising Goals
Each Trot to Clot Walk participant who is age 6 and older will need to register as an individual walker
and pay the $25 registration fee. In addition, each registrant is asked to set a personal fundraising
goal of at least $100. The $25 registration fee is not counted toward the individual’s fundraising goal.
There will be prizes for the top three individuals who raise the most money. Children younger than 6
are welcome to attend but they do not need to register or pay the registration fee.

Collecting Donations
There are three ways for Walk participants to collect donations towards their individual fundraising
goals:

 Ask your friends and family members to go to http://trot2clot.dojiggy.com and make a credit card
  donation for you. They should click on the Make a Donation tab at the top of the page and then
  enter your name or your team name so that you will get credit for their donation.

 Distribute the Donation Form (attached) to your friends and family if they don’t want to contribute
  online. They can send their check directly to Hemophilia of Georgia with this form and you will get
  credit for their donation.

 Collect cash and checks yourself and use the Donation Tracking Form (attached) to keep track of
  who gave you donations. Send the Donation Tracking form to HoG no later than Thursday, June
  10, 2010 with the contributions. Print your last name and Trot on the memo line of the checks (this
  ensures that the donations are properly allocated). Example: Smith – Trot. Be sure to include the
  donor information for each person who gives you money so they will receive the credit for their
  donation and a tax statement. If the donor wishes to remain anonymous, please indicate that on
  the forms.

Contributions can be made online until 3 pm on Thursday, June 10, 2010. Individual fundraising
totals will be calculated at that time and used to award the top three fundraiser individual prizes at the
event on Saturday, June 12, 2010.
Submitting Donations and Forms
All checks and money orders should be made out to Hemophilia of Georgia and submitted along with
a corresponding Donation Form or a Donation Tracking Form. All checks, money orders, and forms
should be clearly marked “Trot” and be mailed to:

   Lorraine Scollan
   Hemophilia of Georgia
   8800 Roswell Road, Suite 170
   Atlanta, Georgia 30350

Checks must be payable to Hemophilia of Georgia and include the walker’s name or team on the
memo line so that the donations can be allocated properly.

General Information about the Trot to Clot Walk

      The Walk will take place at East Cobb Park, 3322 Roswell Road, Marietta, Georgia 30062.
       For directions, visit the park website at www.eastcobbpark.org

      The official Walk route is twice around the 1.2 mile trail. However, walkers are encouraged to
       go at their own pace and to walk as much or as little as is comfortable. There is also a smaller
       paved track around the playground that is perfect for wheelchairs, strollers, and wagons.

      The Walk will take place rain or shine so be prepared and plan ahead!

      Parking at East Cobb Park will be limited. If possible, please carpool with family members or
       teammates.

      Dogs, strollers, and wagons are allowed and encouraged.

      Everyone is welcome at the Trot to Clot Walk! East Cobb Park will be open to the public on
       the day of the event.

      The park has two playgrounds and several picnic areas that you can use after the walk. If you
       choose to bring a picnic lunch, please be aware that glass containers are not allowed in the
       park and portable grills or ground fires are not permitted.

      Teams and individuals are encouraged to have fun and be creative. Suggestions include
       making customized t-shirts, signs, and banners.
                       Trot to Clot Walk Individual/Team Registration Form
                       Please fill out all the blank spaces and return this form with your check or money
                       order. Online registration is available at http://trot2clot.dojiggy.com. Please see
                       www.hog.org/walk for more information about the Walk. Remember, children
                       under 6 years old participate for free.


WALKER INFORMATION:
Are you registering as an individual walker or as part of a team?

     Individual walker

     Part of a team _____________________________________________________________
                                                          (Team name)
Name __________________________________________________________________________

Address ________________________________________________________________________

City, State, Zip ___________________________________________________________________

Email ____________________________________Phone ________________________________

PAYMENT INFORMATION: Make checks/money orders payable to Hemophilia of Georgia

     $25 registration fee

     $______ additional donation (optional)

TOTAL $ _______

 Check enclosed        Check Number _____________

 Credit card:

    Check one:           Amex                    Discover                 MasterCard              Visa

    Name on Credit Card ____________________________________________________________
    Billing Address _________________________________________________________________
    City, ST Zip ____________________________________________________________________
    Credit Card Number ________________________________ Exp. ________ CVV Code _______

        Please mail this form and check to:

        Hemophilia of Georgia Trot to Clot Walk
        8800 Roswell Road, Suite 170
        Atlanta, Georgia 30350
        Attention: Lorraine J. Scollan

No goods or services were received for this donation. Hemophilia of Georgia, Inc. is a Non-profit 501(c) (3)
organization. (Our Federal Tax Id number is # 58-1175625)
                         Trot to Clot Walk Individual/Team Donation Form
                         Please fill out all the blank spaces and make sure that the participant or team
                         you are supporting is listed correctly so that the money is applied to their
                         fundraising goal. Please return this form with your check or money order or
                         make your donation online at http://trot2clot.dojiggy.com. See
                         www.hog.org/walk for more information about this event.


 My pledge is supporting _________________________________________________________
                                                (Individual name)

 My pledge is supporting _________________________________________________________
                                                (Team name)

DONOR INFORMATION:

Name __________________________________________________________________________

Address _________________________________________________________________________

City, State, Zip ____________________________________________________________________

Email ______________________________________Phone _______________________________


PAYMENT INFORMATION: Make checks/money orders payable to Hemophilia of Georgia

 Enclosed is my check in the sum of $ __________________ Check Number _____________

 Please charge my $ _____________ donation to:

    Check one:           Amex                    Discover                 MasterCard              Visa

    Name on Credit Card ____________________________________________________________
    Billing Address _________________________________________________________________
    City, ST Zip ____________________________________________________________________
    Credit Card Number ________________________________ Exp. ________ CVV Code _______

        Please mail this form and payment to:

        Hemophilia of Georgia Trot to Clot Walk
        8800 Roswell Road, Suite 170
        Atlanta, Georgia 30350
        Attention: Lorraine J. Scollan


No goods or services were received for this donation. Hemophilia of Georgia, Inc. is a Non-profit 501(c) (3)
organization. (Our Federal Tax Id number is # 58-1175625)
                                             Donation Tracking Form
  Use this form to keep track of donations that you collect directly. Please mail this form with all checks/money orders to the
              HoG office by June 9, 2010. 8800 Roswell Rd, Suite 170, Atlanta, GA 30350, attn. Lorraine Scollan

  Participant Name:________________________________________________________________________________
  Team Name: ___________________________________________________________________________________
  Address: _______________________________________________________________________________________
  Day Phone: ________________________________________                Cell Phone:_________________________________
  Eve Phone: ________________________________________                Email: _____________________________________
  Goal: $ _____________________________________________


1. Name: ____________________________________                       6. Name: ____________________________________
   Address: _________________________________                            Address: _________________________________
   _________________________________________                             _________________________________________
   Phone: ___________________________________                            Phone: ___________________________________
   Email: ___________________________________                            Email: ___________________________________
   Donation $:________________________________                           Donation $:________________________________

                                                                    7. Name: ____________________________________
2. Name: ____________________________________
                                                                         Address: _________________________________
   Address: _________________________________
                                                                         _________________________________________
   _________________________________________
                                                                         Phone: ___________________________________
   Phone: ___________________________________
                                                                         Email: ___________________________________
   Email: ___________________________________
                                                                         Donation $:________________________________
   Donation $:________________________________
                                                                    8. Name: ____________________________________
3. Name: ____________________________________
                                                                         Address: _________________________________
   Address: _________________________________
                                                                         _________________________________________
   _________________________________________
                                                                         Phone: ___________________________________
   Phone: ___________________________________
                                                                         Email: ___________________________________
   Email: ___________________________________
                                                                         Donation $:________________________________
   Donation $:________________________________
                                                                    9. Name: ____________________________________
4. Name: ____________________________________
                                                                         Address: _________________________________
   Address: _________________________________
                                                                         _________________________________________
   _________________________________________
                                                                         Phone: ___________________________________
   Phone: ___________________________________
                                                                         Email: ___________________________________
   Email: ___________________________________
                                                                         Donation $:________________________________
   Donation $:________________________________
                                                                    10. Name: ___________________________________
5. Name: ____________________________________
                                                                         Address: _________________________________
   Address: _________________________________
                                                                         _________________________________________
   _________________________________________
                                                                         Phone: ___________________________________
   Phone: ___________________________________
                                                                         Email: ___________________________________
   Email: ___________________________________
                                                                         Donation $:________________________________
   Donation $:________________________________
         How do you raise $100 in just 10 days?
                           It’s easy! Ask 10 people for $10!!



       Day 1    Put in your own $10

       Day 2    Ask a significant other, spouse or roommate for $10

       Day 3    Ask your mom or dad for $10

       Day 4    Ask your boss for $10

       Day 5    Ask a co-worker for $10

       Day 6    Ask a friend for $10

       Day 7    Ask your neighbor for $10

       Day 8    Ask a relative for $10

       Day 9    Ask another co-worker for $10

       Day 10 Email another friend and ask for $10




.

Matching Gifts
A great way to get your employer involved, as well as to raise funds, is to participate in
a matching gift program. Contact your employer’s Human Resources Department to
inquire about their policy on matching gifts.


                       On behalf of Hemophilia of Georgia
                          THANK YOU for joining the
                              Trot to Clot Walk
               and for your support of Hemophilia of Georgia!

				
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