Re: Hoops for Hope: Pink Madness 3-ON-3 Basketball Fundraiser (Breast Cancer Awareness)

There will be a 3-on-3 basketball fundraiser held on Wednesday, October 29,2014 to raise money for Breast Cancer Research. Mr. Alexandros Tsironis and Mr. Lorenzo Prillman, 3-on-3 program sponsors, will hold the “Hoops for Hope: Pink Madness Challenge” in the school Gym from 12:10 – 2:10 p.m. Students who would like to participate in the fundraising event will have an opportunity to sign-up for a team, during lunch time, on Monday, October 13through Thursday, October 16, 2014.

After students sign-up for a 3-on-3 basketball team, they will be encouraged by the event sponsors (Mr. Alexandros Tsironis & Mr. Lorenzo Prillman) to seek out sponsorships for playing in the “Hoops for Hope: Pink Madness Challenge.” Student sponsors will make a monetary donation to be gifted to the American Cancer Society to support Cancer Research. Monetary donations can be submitted to the 3-on-3 program sponsors at the Blair G. Ewing Center (Alternative Programs) or directly to the American Cancer Society.

Additional information on how to make monetary donations can be found on the form titled “How to Sponsor a Student.” All students/parents will be expected to read, sign and submit the 3-on-3 basketball tournament “Liability Waiver” form prior to the day of the event. If parents/guardians have any additional questions regarding the program, please feel free to contact Mr. Lorenzo Prillman at 301-279-4922 or by email: . Thank you.

Lorenzo R. Prillman

Resource Teacher

Alternative Programs

14501 Avery Road

Rockville, MD 20853

HOW TO SPONSOR A STUDENT

Student Name: ______

Donor Name: ______

Address: ______

City: ______State: ______Zip: ______

Phone: ______Fax: ______

Email: ______

Signature: ______

Donate and Save Lives

Join the fight against cancer by donating to the American Cancer Society

How much would you like to donate?

  • $25.00
  • $50.00
  • $75.00
  • $100.00
  • Other ______(please write in the amount you wish to donate)

Cash payments accepted or go to the “American Cancer Society” website, listed below, and make a donation. Print out an e-mail confirmation of your donation and give it to the student you’re sponsoring. Your student will submit the donation conformation form to the event sponsor, Mr. Lorenzo R. Prillman.

Location: Blair G. Ewing Center (Gym)

Time: 12:10 – 2:10 p.m.

REGISTRATION FORM

Team Name: ______

Boys or Girls (circle one)

First and Last Names, Age, Height and T-Shirt Size (circle size)

(1st)______Age ___ Height ____ T-Shirt size S M L XL XXL

(2nd)______Age ___ Height ____ T-Shirt size S M L XL XXL

(3rd)______Age ___ Height ____ T-Shirt size S M L XL XXL

(4th)______Age ___ Height ____ T-Shirt size S M L XL XXL

Team Captain: ______

Alternative Programs

3-on-3

Basketball Tournament
Liability Waiver

As a participant in the 3-on-3 basketball tournament, I recognize and acknowledge that there are certain risks of physical injury to participants and I agree to assume the full risk of any injuries, including death, damages, or other loss which may be sustained as a result of participation in any and all sports activities. I, as a participant, hereby agree to waive and relinquish any and all claims I may have as a result of participation in the program.

The undersigned further agrees to indemnify and hold harmless MCPS and its membership, moderators, officers, agents, and employees from any and all actions, claims, and demands resulting from any injuries, including any injuries incurred during the basketball tournament and/or while traveling to and from such sports activities.

I have read and fully understand the above waiver.

Name of participant:______
Signature of parent/guardian:
______
Date:
______

Hoops for Hope: Pink Madness Challenge

3-ON-3 Basketball Fundraiser

(Breast Cancer Awareness)

When: Wednesday, October 29, 2014

Where: Blair G. Ewing Center GYM

Time: 12:10 – 2:10 p.m.