2018 Polar Bear Pledge Sheet

Participants Name: ___________________________________________________________________

You must be 18 years of age or older to participate, youths age16 to 17 may participate only if a parent or legal guardian has given written permission.

Sponsor	Amount
1. __________________________________________________________	____________________
2. __________________________________________________________	____________________
3. __________________________________________________________	____________________
4. __________________________________________________________	____________________
5. __________________________________________________________	____________________
6. __________________________________________________________	____________________
7. __________________________________________________________	____________________
8. __________________________________________________________	____________________
9. __________________________________________________________	____________________
10. _________________________________________________________	____________________
11. _________________________________________________________	____________________
12. _________________________________________________________	____________________
13. _________________________________________________________	____________________
14. _________________________________________________________	____________________
15. _________________________________________________________	____________________
16. _________________________________________________________	____________________
17. _________________________________________________________	____________________
18. _________________________________________________________	____________________
19. _________________________________________________________	____________________
20. _________________________________________________________	____________________
21. _________________________________________________________	____________________
22. _________________________________________________________	____________________
23. _________________________________________________________	____________________
24. _________________________________________________________	____________________
25. _________________________________________________________	____________________
26. _________________________________________________________	____________________
27. _________________________________________________________	____________________
28. _________________________________________________________	____________________
	Total ____________________
Pledge sheet will be collected at time of swim