Terry’s Tanzania Trek

3rdAnnual Terry Berg
5K Run/Walk

Saturday, June 15th, 2013

Ridge Run Park

Scenic Drive Entrance – at Wheat Ridge Lane

West Bend, WI

8:00 am for Registration and T-shirt pick-up

9:00 am Run/Walk begins.

Rev. Terry Berg was a pastor, husband,father, grandfather, mentor, and good friend to many. Terry was also a Board member of Brick by Brick for Tanzania!,Inc. If it had not been for Terry’s inspiration and passion for this project, Brick by Brick would not be building schools today. Upon his death in November 2010, it was decided to honor his memory by lifting up this important mission.

Brick by Brick for Tanzania!,Inc.is a non-profit that builds schools in Tanzania. Rev. Terry Berg was a strong advocate of Brick by Brick for Tanzania and in 2011 we raised enough money to build a school in his name, ‘The Terry Berg School at Ndoombo.’ Our mission is to continue to raise money to build schools in Tanzania to honor what Terry continues to mean in our lives. For further information visit.

Please mail your registration form by June 10th. Registrations will also be accepted on the day of the walk. Bring your pledge form along with cash/checks made payable to Brick by Brick for Tanzania! Inc. to the walk.

Directions

Hwy 45 to West Bend, exit on Hwy 33 – go west to Scenic Drive – south on Scenic to Wheat Ridge Lane – turn east to park entrance.

ParticipantsToDo List:

  1. Complete the registration form. Include your check for $15.00 made out to Brick by Brick for Tanzania,Inc. Mail by June 10th, 2013 to:

Karen Berg

2818 Valley Ave

West Bend, WI 53095

  1. Collect pledges
  1. Join us for the run/walk on June 15th. Bring your pledge form and pledges collected.

Terry’s Tanzania Trek

3rdAnnualTerry Berg

5K Run/Walk

Saturday, June 15th, 2013

Ridge Run Park

Scenic Drive Entrance – at Wheat Ridge Lane

West Bend, WI

Entry Form (please print)

Name ______

Address ______

City ______State ______Zip ______Phone Number:______

T-Shirt Order (circle one)Short-Sleeve T-Shirt

Child: S (6-8)M (10-12)L (14-16)

Adult: S M L XL XXL

Payment Information – Registration includes a t-shirt for each person.

Registration Fee Enclosed$______$15.00Registration before June 10th

$______$20.00 Day of the race fee $______$10.00 Children under 12 $______$50.00 Family Fee

Pledges Collected $______Can be turned in day of the race.

Total Enclosed $______

Please make checks payable to Brick by Brick for Tanzania, Inc.

Neither Brick by Brick for Tanzania, Inc. nor the organizers of the Terry Berg 5K Run/Walk are responsible for any problems or injuries incurred while taking part in this fundraiser. I agree not to bring a lawsuit against Brick by Brick for Tanzania, Inc. or anyone associated with the event. I agree I am the only one responsible for my personal items. I also agree to the use of my name and pictures in any broadcast, telecast, or print media account of this event. In filling out this form, I acknowledge and fully understand my own liability and do accept the restrictions.

______

Signature Date

______

Parent’s Signature (if under 18)Date

1.Complete the registration form. Include your check for $15.00 made out to Brick by Brick for Tanzania, Inc. Mail by June 10th, 2013, to Karen Berg – 2818 Valley Ave, West Bend, WI 53095

2.Collect pledges

3.Join us for the run/walk on June15th. Bring your pledge form and pledges collected.

Terry’s Tanzania Trek

3nd Annual Terry Berg

5K Run/Walk

Saturday, June 15th, 2013

Ridge Run Park

Scenic Drive Entrance – at Wheat Ridge Lane

West Bend, WI

Pledge Form

Pledges are greatly appreciated, but not required to participate.

Our goal is for each participant to raise $100 in pledges.

Participants Name: ______

Special Recognition will be given during the Closing Ceremonyfor anyone raising over $100 in pledges.

I, ______, have collected the following pledges as a participant of this event.

Name Address Pledge Amount

______$______$______$______$______$______$______$______$______$______$______$______$______

For additional pledges, please use another pledge form.

Please collect all pledges and have all checks made payable to Brick By Brick for Tanzania!, Inc.

Signature (Guardian if under 18) Print Name