Power Down
Electronics Blackout Marathon
12-7 p.m., Saturday, May 14 @ Ford City Library
First Name:______Last Name:______
I plan to power down for at least []hours for Ford City Public Library.
Dear Potential Sponsor,
I am participating in the Ford City Public Library Power Down, an electronics blackout marathon. All proceeds will help fundyouth activities at Ford City Library. You can sponsor me for an amount per ½-hour increments and can name a maximum amount that you are willing to contribute. Within the week following the event, I will return to tell you how many hours I spent without using electronics and collect your contribution. Make checks out to Ford City Public Library or FCPL. All contributions are tax-deductible.
Thank you!
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Participants:
To reach our goal, we hope that each participant finds at least ten sponsors.
Please bring this form to the library on the day of Power Down, 12 p.m., Saturday, May 14.
Ford City Public Library
Power Down
Electronics Blackout Marathon
12-7 p.m., Saturday, May 14 @ Ford City Library
Our blackout marathon is a fun activity for local youth, with all participantsstrivingto enjoy their time without electronics. Kids, ages 10-15, set realistic goals based on age and development. Drinks and pizza dinner will be provided and awards given for exceptional participation.
Our goal is to help the library raise at least $1000 to fund youth programs. If each participant raises $100, we will achieve our goal. Thank you very much for your participation!
Rules
1.Participants may start collecting pledges as soon as they receive the pledge sheets. Reminder: Pledge sheets need to be checked by event leaders on the day of Power Down, May 14.
2.Pledges may be made by anyone. However, participants may not ask for pledges from any of the staff members of Ford City Library. Each sponsor making a pledge should write their own name, pledge in ½-hour increments and maximum pledge. Students may collect the pledge in advance but must keep pledges until May 14.
3.On the day of the event, participants will assemble at the library at 12 p.m.The event is seven hours long. Each participant will be issued a “Power Down Tag,” which will be punched each half hour the participant goes without using electronics, thereby keeping track of the number of ½-hour increments completed.
4.Participants will not leave the supervision of event leaders without expressed permission from the leaders.
5.Participants will not use electronics, including cell phones, for the duration of the event. Cell phones and other electronics brought to the event will be collected, tagged and placed in the library safe until the participant has completed Power Down activities. All devices will be returned to participants before they leave for home, regardless of the time.
6.Participants will not engage in unlawful, abusive or disruptive behavior and will cooperate with library staff & representatives
7.Upon completion of Power Down, participants will hand in their tags. Anevent leader will record each participant’s total hours of participation on their pledge sheet and return it. The library will keep a copy of each pledge sheet and any pledges that have already been collected. Participants may then collect outstanding pledges.
Please return pledge sheets with any outstanding pledge money to Ford City Library by the end of business Wednesday, May 18, 2016.
PROGRAM PARTICIPANT
By signing this form, I acknowledge and understand the rules for Power Down and promise to follow them.
Signature of Participant______Date______
We look forward to all our participants having a great time! For questions or concerns or to volunteer, contactAnita Bowser at 724-902-0946 or .
Ford City Public Library
1136 4th Ave., Ford City, PA 16226
724-763-3591 (phone)
724-763-2705 (fax)
PARENT OR LEGAL GUARDIAN
I heretofore grant my permission for ______
To participate in Power Down: An Electronics Blackout Marathon, 12-7 p.m., May 14 at Ford City Library.
By signing this permission form, I understand the following:
- Parents must provide a phone number where they can be reached during the event in case of emergency.
- Some activities may take place at 7th Avenue Playground, under the supervision of program staff.
- Most activities will take place at Ford City Public Library.
- In consideration of the agreement of the Ford City Public Library to allow my child’s participation, and intending to be legally bound hereby, I agree, indemnify and hold harmless the Ford City Public Library, the officers and board members, their agents, successors, and legal representative, against any loss from any and all claims, demands and actions at law or in equity that may hereafter at any time be brought by me or by anyone acting on my behalf, for the purpose of enforcing a claim for damages because of any injury to me or any cause of action of any kind or nature as a result of, or in any way related to my child’s participation in the above-mentioned activity or my transit thereto.
- I agree that in case of injury to my child, I will apply my hospitalization or accident insurance toward the payment of the expenses incurred and will not look to the Ford City Public Library, the Board of Directors or any agents, successors or assigns for the payment of any medical costs or injury-related costs.
Signature of Parent or Legal Guardian______Date______
Phone Number where Parent or Legal Guardian can be reached during the event:
______