1st Annual 2004 - Clinton Fish and Game Club

Marathon Shoot for Hospice & Palliative Care

July 31st, 2004 - Test of Endurance for Hospice & Palliative Care

Individual Sponsor Sign-up Sheet
 Sponsors Name   
 Address   
 City/State,Zip   
 Phone Nbr   
 EMail Address   

 Shooters 
 Name 
 Amount Per 
 Broken Target 
 Single $ 
 Donation 
 Not To 
 Exceed $ 
       
       
       
Total Amount       

EXAMPLE
 David Cruger  $0.01    $7.50 
 Al Paniccia  $0.02    $15.00 
Total Amount   $0.03    $22.50 

In this example the pledge is 1 cent per broken target for David and 2 cents per broken target for Al.
Total donation not to exceed $22.50.
If David breaks 600 targets out of 1000 at 1 cent the total donation for David will be $6.00
If Al breaks 700 out of 1000 at 2 cents the donation amount will equal 700*.02=$14.00
This will bring the total donation to $20.00

Of course for those people who want to keep things simple a single donation is always welcome.
No amount to small to accept. All donations are welcome.

To sign-up print this form and mail it to the CFAG at the address listed below. Or Click the On Line Form link
Make checks payable to "Clinton fish and Game Club" memo: "Hospice"
If you happen to see David, John or Al around just give them the form and they will be happy to turn it in for you.

Clinton Fish and Game Club
P.O Box 122
Clinton, NY 13323
315-853-8787
WebPage:
www.clintonfishandgameclub.com
EMail To: John La Porte
Hospice & Palliative Care, Inc.
Middle Settlement Road
New Hartford, NY 13413
315-735-6484
315-793-8852 Fax
WebPage:
www.hospicecareinc.org
EMail To: Stephanie R. Hale
Development Assistant