2015 Great Bay Half Marathon Beyond the Rainbow 5K Race Charitable Contribution Pledge Form First Name:___________________________________ Last Name: ______________________________ Dear Potential Sponsor, I am participating in The Beyond the Rainbow Fund 5K Race on April 12, 2015, as part of the annual Great Bay Half Marathon races. 100% of the proceeds I collect will benefit Exeter Hospital’s The Beyond the Rainbow Fund which provides financial assistance and support to patients in need at Exeter Hospital’s Center for Cancer Care. This fund has been able to provide assistance with rent, utility and fuel bills, groceries, transportation expenses, as well as other practical needs that may become unmanageable for a patient during their treatment. This fund also provides patients with wellness/fitness programs and integrative therapies, such as massage, that further assists them in improving their quality of life as they focus on healing and recovery. You can sponsor me for an amount per mile or can name a maximum amount that you are willing to contribute. After the 5K race, I will return to tell you how far I ran or walked and collect your contribution. Contributions are tax-deductible. Please consider supporting your neighbors in need. It may make a world of difference in what could be the fight of their life. Please make checks payable to: Exeter Hospital (The Beyond the Rainbow Fund noted in the memo section) Name of Sponsor Phone Number Maximum Pledge 1 $ 2 $ 3 $ 4 $ 5 $ 6 $ 7 $ 8 $ 9 $ 10 $ 11 $ 12 $ 13 $ 14 $ 15 $ 16 $ Total Contribution $ Amount Collected from Sponsor Great Bay Half Marathon – Beyond the Rainbow 5K Charitable Contribution Pledge Form How it works 1) Secure commitments from friends, family, co-workers, etc. prior to the race. 2) AFTER the race on April 12th, collect all the contributions from your pledges. Make sure all checks are made payable to: Exeter Hospital (The Beyond the Rainbow Fund noted in the memo section). Send checks and a copy of the form directly to Exeter Hospital, Community Relations and Advancement, 5 Alumni Drive, Exeter, NH 03833. Questions: Please contact Carrie Shaw, Exeter Hospital, Community Relations and Advancement Department at 603-702-0551 or cshaw@ehr.org with any questions regarding this fund. Thank you for your support.