Dancer Information

v  Dancers must be willing to be on his/her feet for the entire night of March 21st, 2013 from 5:00 PM to 11:00 PM.

v  Students must raise a minimum of $50 in order to become a dancer.

v  All money is due to Mrs. Ebersole, one of the Mini-THON heads, or your respective Mini–THON Class Representative on or before Thursday, March 7th, 2013. (Seniors – Nicolas Sanchez, Kristina O’Sullivan, Juniors – Rob Baurley, Kellie Keen)

v  Dancers should hand in their commitment form, with parent and student signature, to Mrs. Ebersole in room E-206 ASAP.

v  Dancers should hand in their publicity release form, with parent and student signature, to Mrs. Ebersole in room E-206 ASAP.

v  Dancers may bring money in as often as possible. Every time a dancer brings their money in, they should also hand in a copy of their pledge grid. You keep the original pledge grid for your records.

v  All dancers may be signed up for and participate in any number of games/activities throughout the 6 hours of Mini-THON. Some competitions will necessitate sign-ups weeks in advance (i.e. the dance competition and lip-sync competition). Any questions about this should be addressed to Mrs. Ebersole. Each game/activity at Mini-THON will be awarded points for first, second, third and fourth place. At the end of the night we will crown the winning grade of Mini-THON

v  Any questions can be brought to Mrs. Ebersole, Mrs. Rieger, Nicolas Sanchez, Kristina O’Sullivan, Rob Baurley or Kellie Keen. Please pay attention to forum news as information will be supplied regularly.

v  Please dress appropriately for Mini-THON. Comfortable and active clothing, socks, and sneakers should be worn. Many students also choose to wear decorative accessories in their grade’s color.

v  Please bring your own water bottle as we continue to go green.


2013 Mini-THON Dancer Commitment Form

Dancer: ______

Address: ______

Home Phone: ______Cell Phone: ______

Locker #: ______Grade: ______

Forum Room #: ______T-Shirt Size: S M L XL XXL

Parent/Guardian Name(s) ______

Agreement:

I will be on my feet for the entire six hours of Upper Merion High School's Mini-THON on Thursday, March 21st, 2013 from 5:00 PM to 11:00 PM. I know I am required to participate in multiple events as scheduled by my class representatives. I also know that I am representing myself, my class, and my school, and therefore I will act with dignity and respect in all aspects of the day/night.

Dancer Signature ______

Parent/Guardian:

I allow my son or daughter to participate in Upper Merion's Mini-THON on Thursday, March 21st, 2013.

Parent/Guardian Signature ______


Upper Merion Township School District

Publicity Release

Dear Parent/Guardian:

Photos, videotape footage and personal interviews with Upper Merion students who are involved in various school-related activities are often used as part of the district’s community relations efforts (e.g. district publications, local television programs, newspapers, and on the school district’s website).

By signing below you are granting permission to the School District to photograph or videotape the person named below. The photographs would be used in school-related publications, such as the district calendar, newsletter, district website and local media.

The Upper Merion Township School District is sincere in its commitment to keep the public informed of the programs, activities, and events that are taken place in our schools. Without your permission, you child cannot be part of this endeavor. However, in situations in which large groups are participating, it is impossible not to photograph certain students. Therefore we cannot prevent the use of photos that unintentionally include your child.

______

______I DO consent to have a photograph, video or information that includes my child submitted in releases for publication and public distribution.

______I DO NOT consent to have a photograph, video or information that includes my child submitted in releases for publication and public distribution.

______

Student’s Name (please print) Date

______

School/Grade

______

Parent’s Signature

PLEASE RETURN THIS FORM

TO MRS. EBERSOLE OR A THON HEAD ASAP

PLEDGE GRID
Dancer's Name:
Donor /
Address / Phone Number / Email / Donation
TOTAL AMOUNT RAISED:
PLEDGE GRID
Dancer's Name:
Donor /
Address / Phone Number / Email / Donation
TOTAL AMOUNT RAISED:

UPPER MERION

2013 Mini-THON Pledge Form

Donor: ______Donation: ______

Dancer: ______

Address: ______

Phone Number: ______Email: ______

Proceeds Benefit The Four Diamonds Fund

Helping Kids with Cancer

For tax purposes, our federal ID number is 23-6003908

UPPER MERION

2013 Mini-THON Pledge Form

Donor: ______Donation: ______

Dancer: ______

Address: ______

Phone Number: ______Email: ______

Proceeds Benefit The Four Diamonds Fund

Helping Kids with Cancer

For tax purposes, our federal ID number is 23-6003908

UPPER MERION

2013 Mini-THON Pledge Form

Donor: ______Donation: ______

Dancer: ______

Address: ______

Phone Number: ______Email: ______

Proceeds Benefit The Four Diamonds Fund

Helping Kids with Cancer

For tax purposes, our federal ID number is 23-6003908

UPPER MERION

2013 Mini-THON Pledge Form

Donor: ______Donation: ______

Dancer: ______

Address: ______

Phone Number: ______Email: ______

Proceeds Benefit The Four Diamonds Fund

Helping Kids with Cancer

For tax purposes, our federal ID number is 23-6003908

UPPER MERION

2013 Mini-THON Pledge Form

Donor: ______Donation: ______

Dancer: ______

Address: ______

Phone Number: ______Email: ______

Proceeds Benefit The Four Diamonds Fund

Helping Kids with Cancer

For tax purposes, our federal ID number is 23-6003908

UPPER MERION

2013 Mini-THON Pledge Form

Donor: ______Donation: ______

Dancer: ______

Address: ______

Phone Number: ______Email: ______

Proceeds Benefit The Four Diamonds Fund

Helping Kids with Cancer

For tax purposes, our federal ID number is 23-6003908