All participants will be required to sign a waiver at the walk.

If you would like a receipt mailed to you please indicate address for mailing. Thank you for
supporting Childhood Stroke Awareness and Children's Hemiplegia and Stroke Association.
REGISTER HERE IF YOU WOULD LIKE TO PAY BY CHECK OR CASH
4th ANNUAL CENTRAL FLORIDA walk for

CHILDHOOD STROKE
AWARENESS

If you have any questions, please call Melanie 407-970-5220
to benefit
put your name here....
Your name:
Your email address:
Your phone number:
Number of Walkers:
Additional names:
please list
T-Shirt Sizes:
 Number of T-Shirts:
Youth Small
Youth Medium        
Adult Small
Adult Medium        
Adult Large        
Adult XL
Adult XXL
Pledged Amount:
Comments:
A BIG THANKS TO OUR SPONSORS:
An AchievAbility LLC Company
“A Sensory Gym on Wheels”
put your name here....
SPONSORSHIP OPTIONS

In addition to your company name/logo prominently displayed on the walk t-shirt to be supplied to all registered walkers, you will receive
recognition (with your Level Sponsor) on the website, social networking sites, e-newsletter, signage at the walk, plus:

  • Diamond Level, $1000
Special recognition at the event as the lead sponsor of the event, predominant placement on walk t-shirt, banner  and brochures.      
Sponsors’ brochures may be placed on an information table and/or  in take-home bags

  • Platinum Level, $500
Central, prominent placement on walk t-shirt and  banner

  • Gold Level, $500
Mid level prominence on walk t-shirt and banner
RICHARD E. DECANTIS, D.D.D.S, P.A
E. DAVID BRINKLEY, JR., D.D.S

FAMILY DENTISTRY

475 WEST BROADWAY, SUITE 3
OVIEDO, FL 32765

407-366-0391