______
REGISTRATION FORM TO SUPPORT THE FAStrap© walk
We would like to thank you for your interest in supporting the above mentioned awareness campaign.
As you know, 9th September is International Fetal Alcohol Syndrome (FAS) day. FAS is caused when a pregnant woman consumes alcohol during her pregnancy, resulting in permanent damage to her unborn child. Thus the “9” in the date 09/09 is symbolic of the 9 months of an alcohol free pregnancy.
De Aar had until recently the highest FAS prevalence rate in the world. This rate has thus far been reduced by 30%, due to the Foundation for Alcohol Related Research/FARR’s FAS prevention program in De Aar. This is the first reported decrease in a FAS community prevalence rate anywhere in the world. FARR has been invited to conduct a similar programme in Kimberly in 2012.
In recognition of the hard work and commitment of the community groups and the pregnant women in De Aar, and to raise the awareness regarding FAS in South Africa, the CEO of FARR Leana Olivier and Area Coordinator, Lian Drotsky, will walk from De Aar to Kimberley from 17 – 24 October 2011. During this 380 km FAStrap© walk they will cover 380 km. Along the way they will address schools and community groups on the prevention of FAS.
The launch of FAStrap© will take place on 9 September 2011 at Beyerskloof and will be broadcasted live by Radio Sonder Grense allowing us to reach a much larger audience. We urge communities to show their support through the “FAStrap© supporting steps” journey by running walking or even rollerblading for 9km’s each. You are welcome to complete the 9km in absolutely any format, whether its 9kms once off, or 1km daily until you reach a total of 9km. This campaign starts on the 9th September and finishes on the 16th of October 2011. Our aim is to get 111 people to complete a combined distance of 999km. Once we reach the target the walkers can deduct 90 km from the walk from De Aar to Kimberley. We trust you will support us!!
To register for the “FAStrap© supporting steps” journey we ask you to do the following
1. Complete the attached entry form and post or fax it to or fax number 086 689 9319. Ina’s cell number is: 0834634090
2. Tell as many of your friends, family and colleagues about the FAS awareness campaign. You are welcome to refer them our website. www.farr-sa.co.za
PLEASE COMPLETE THE FOLLOWING FORM:
Surname: …………………...……………………………………………………………………
Name: ………..………………………………………………………………………………
Telephone no: …………………………… Email/fax no: ……….……………………………
Residential area/town: ……………………………………………………………………………….
How have you supported the FAStrap walk?
□ walked 9 km
□ walked 9 km as a relay
□ ran 9 km
□ other
Please describe what you have done :
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………
I, hereby give permission that the above mentioned information may be used on FARR website and that my 9kms can be added onto the barometer.
I choose the following option:
□ may use my original name on the website
□ may use this “false” name: …………………………………………………………………..
Thank you very much and for all the support!
Leana en Lian
FAStrap team
______
Foundation for Alcohol Related Research
Association incorporated under Section 21
Registration Number: 1997/00190/08
VAT Registration: 4610166615
HWSeta Accreditation: HW591PA1011091
Non Profit Organisation Reference No: 089-368
BBBEE: BRSE004022
PBO: 18/11/13/536
37 Thornhill Road • Rondebosch • Cape Town • 7700 • South Africa
Tel: (+27) (21) 686 2645 / 6 / 7 • Fax (+27) (21) 685 7034
e-mail: • www.farr-sa.co.za
Directors: Prof DL Viljoen (Chairperson), Prof JP van Niekerk, Dr L Bhengu, Mr AGP Botha, Ms A Sheik, Dr M Urban, Ms L Olivier