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Deliverance Ministry and Healing Center318 Wilson Street, Martinsburg, WV 25401Pastor Arlethia Dupree-JonesPRESENTSSeptember 12, 2015City of MartinsburgRegistration @ 8 am Downtown SquareParticipant Packet
Dear Participant,Thank you for your interest in assistance Deliverance Ministry and Healing Center in our efforts tocombat hunger in Berkeley County.Deliverance Ministry and Healing Center , founded and lead by Pastor Arlethia Dupree- Jones iscommitted to meeting the spiritual and physical needs of our youth and their familites in BerkeleyCounty.This Walk-A-Thon is to sponsor a Feed the Children event on October 3, 2015 to feed 400 youthand families in Berkeley County. All the proceeds will be used to combat hunger in BerkeleyCounty. While this is a temporary solution, our goal is to link with the families to create longlasting life changes that will equip them to overcome this barrier. By getting involved you arecommitting to join the fight against hunger.After you have registered, please share our goals with your friends, family, co-workers andcommunity organizations to get sponsors for your walk/run. The 5K walk/run is a fun way ofgetting involved. In order to be successful, you will need to get sponsors, as the goal is to raise 12,000 during this event to cover all the cost assoicated with giving away food to 400 families.The families will received the donation at no cost!Enclosed you will find :1. A Registration Form – This must be completed and submitted with the 25 registration feeby September 2, 2015.2. A Release of Liability Form- This must be submitted with your Registration Form.3. A Pledge Sheet- This is where you list your sponsors and his/her commitment. Yoursponsor may pledge a designated amount or pledge based on the distance you complete.Please collect your designated pledges and bring on the day of the event.4. A Media Release Agreement- This form shall be submitted with you Registration Form,allowing Deliverance Ministry and Healing Center to take and use photos of you from theevent.Please share this event on your social media and get others involved. If you are committed toserving the community, please speak with one of our respresentatives at the event or contact us at304-264-9800 or www.deliveranceministryhc.comThank you for your service and passion for the needs of our youth and families.Yours in Service,Arlethia Dupree-JonesPastor Arlethia Dupree-JonesDeliverance Ministry and Healing Center
REGISTRATION FORMDeliverance Ministry & Healing CenterWalk-a-Thon1. Date and Time of Event: Deliverance Ministry and Healing Center invites you to “Walk for Hunger” onSaturday, September 12, 2015, 9am to 11am in Downtown Martinsburg. The walk-a-thon will beginwith a welcome and prayer by Pastor Arlethia Dupree-Jones or designee in the Martinsburg DowntownSquare.2. Our purpose for the walk-a-thon: We are organizing the walk-a-thon to raise funds for the Feed theChildren event which will feed 400 Berkeley County Families in need. The food packages will be wellbalanced, name brand, quality items given away at no cost to the families on October 3, 2015. We needto raise 13,000 to facilitate this event with 100% of all monies raised going directly to this project. Weneed volunteers of varying ages for the Feed the Children Walk-a-Thon.3. Your Role: We would like you and/or your organization to play a prominent role in this walk-a-thon. Wereally appreciate your participation.Full Name:Age:Preferred Mailing Address:City: State/Province: Zip/Postal Code:Telephone: Email:Are you physically fit to run or walk 5K? YES NO List any medical conditions you are currently being treated for:Walkathon Registration Fees: Includes T-shirt.Student 15 Non-Student 25Payment Method:Check or Money Order must be payable to: Deliverance Ministry and Healing CenterPlease check appropriate box: Check Money Order CashPlease mail or submit in person completed registration form with payment to:Deliverance Ministry and Healing Center318 Wilson StreetMartinsburg, West Virginia 25401Phone: 304-264-9800Email: jallen@deliveranceminsitryhc.com
Waiver of LiabilityDeliverance Ministry & Healing CenterWalk-a-ThonEach participant must complete and sign a Waiver form to be a part of theFeed the Children Walk-a-thon.Completed forms should be mailed or dropped off byWednesday, September 2, 2015 to:Deliverance Ministry and Healing Center318 Wilson Street, Martinsburg, WV 25401Feed the Children Walk-a-thonSaturday, September 12, 20159 AMRain or Shine**In case of rain, the walk-a-thon route will be shortenedand walkers will be credited for the full distance.Participant InformationNameAddressCity, State, ZipStatement of Liability Waiver:In consideration of my being permitted to participate in the Deliverance Ministry andHealing Center, Feed the Children Walk-a-Thon, I hereby expressly waive and release,on behalf of myself, my heirs and anyone assigned to me, any and all rights, claims, andactions against Deliverance Ministry and Healing Center and Feed the Children, Inc.,their officers, employees or agents and any other person connected with the Feed theChildren Walk-a-thon for any injuries and/or damages whatsoever which I incur orexperience as a participant and/or as being connected with or resulting from myparticipation in this Walkathon. I attest that I am physically fit and fully prepared for thisevent.XSignature of ParticipantXPrinted Name of ParticipantXSignature of Parent or GuardianXPrinted Name of Parent/Guardian*Any participant under the age of 18, must have permission from his/her parent/legal guardian
Deliverance Ministry and Healing CenterSponsor FormMake Checks Payable to: Deliverance Ministry and Healing CenterPrint Sponsors NameStreet 81920Total Collected From This Page:TotalReceived
Print Sponsors NameStreet 121314151617181920Total Collected From This Page:Total Collected From Both Pages:Securing Sponsors: Take your sponsor sheet to family, friends, work or local businesses that you thinkmight be willing to sponsor you. Explain: Who you are; What the Walkathon is for; Where the Walkathonroute is located; Why you are walking or running; what the project is promoting and how many miles youintend to complete. Ask for a flat donation to be collected now.Walkathonwilltake place rain or shine.
20102Deliverance Ministry & Healing CenterFeed the ChildrenWalk-a-ThonWalkathon Tips and RemindersMark your calendar! Event Saturday, September 12, 2015 - Rain or ShineRegistration begins at 8AMWalkathon begins at 9 AM.All participants must complete and sign a Liability Waiver and allrequired forms (available with registration packet and at registrationtable the day of event).All Walk-a-thon routes will be open from 9 to 11 AMPlease ensure you check in at the Registration Table on Walk-a-thonDay.For safety reasons, no wheels are allowed. No bicycles, roller blades,skates or skateboards. Only strollers pushed by adults are permitted.Due to allergies, please leave pets home.Please join us after the Walk-a-thon for a celebration of praise!Families are encouraged to bring a picnic lunch to enjoy after theWalk-a-thon.Our special thanks to Our hosts: City of MartinsburgAnd most importantly All of our participants, vendors and supporters for helping make to the2015 Feed The Children Walk-a-thon a huge success for DeliveranceMinistry and Healing Center and the families of Berkeley County!.
Media Release FormDeliverance Ministry & Healing CenterWalk-a-ThonCONSENT AND RELEASE FOR WALK-A-THON PARTICIPANTSTO BE FILMED/ PHOTOGRAPHED/ INTERVIEWEDAND FOR USE OF IMAGE/VOICEI, , hereby irrevocably grant toDeliverance Ministry and Healing Center (DMHC) and Feed the Children(FTC), Inc., their successors, and their assignees the right to record my imageand/or voice on videotape, on film, in photographs, in digital media and inany other form of electronic or print medium and to edit such recording attheir discretion.I understand that my full name, address and biographical information will notbe made public. I further grant DMHC and FTC , their successors, and theirassignees the right to use, and to allow others to use, my image and/or voiceon the internet, in brochures, and in any other medium and hereby consentto such use.I hereby release DMHC and FTC, their successors, and their assignees andanyone using my image and/or voice, pursuant to this release from any andall claims, damages, liabilities, costs and expenses which I now have or mayhereafter have by reason of any use thereof.I understand that the provisions of this release are legally binding.Participant or Parent/Guardian (if participant is under 18) [Print Name]Participant or Parent/Guardian (if participant is under 18) [Signature]DateThank you again for your
Deliverance Ministry & Healing Center Walk-a-Thon 1. Date and Time of Event: Deliverance Ministry and Healing Center invites you to "Walk for Hunger" on Saturday, September 12, 2015, 9am to 11am in Downtown Martinsburg. The walk-a-thon will begin with a welcome and prayer by Pastor Arlethia Dupree-Jones or designee in the Martinsburg Downtown
