(For Office Use Only)
Name of Runner/Walker:
Address:
Phone Number:		Postal Code:
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Please make cheques payable to London and Area Running Association (LARA) TOTAL PLEDGED                            London and Area Running Association (LARA) is a not-for-profit association; receipts can be issued if requested, but they cannot be used for tax purposes. TOTAL REMITTED

Instructions: In order to be eligible for great prizes, please complete your pledge form and collect the money before Race Day. 
Bring both the completed form and all pledge money to the Pledge Table by 10:00am on Race Day.