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Camping for a Cause

Pledge & Registration Form

Welcome House of South County
8 North Road Peace Dale, RI 02879
(401) 284-0122 Ask for: Robin Ehle/Meyer

Grab a box or pitch a tent to bring awareness to homelessness in South County!!

When: Friday, November 22
Time: 6:00 pm to 8:00 am
Location: Old Mountain Field, Peace Dale RI
Raise as much money as you can for a great cause!!

Phone_________________________ Email_______________________
I will be sleeping in a (please circle one) a BOX or a TENT that I am providing.
Sponsor Amount

Please make checks payable to Welcome House of South County
Please return forms and money by November 20, 2013 Total_______

!"#$%&' l hereby walve all clalms agalnsL Welcome Pouse of SouLh CounLy, sponsors or any personnel for any ln[ury l mlghL
suffer ln Lhls evenL. l granL full permlsslon Lo use phoLographs of me and quoLaLlons from me ln leglLlmaLe accounLs and
promoLlons of Lhls evenL.
______________________________________ _________________________________________
SlgnaLure arenL//Cuardlan slgnaLure, lf under 18
lease 8rlng:
- 1enL lf you would llke, boxes wlLh
be provlded
- 8lankeLs
- lllows
- AnyLhlng else Lo keep you warm!
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