PUSHUPS FOR PEACE

Saturday, April 30, 2011

St. Ambrose University in Lee Loman Arena

Guinness World Record Attempt & Fundraiser for:

Quad City Children’s Therapy Center; Kids Against Hunger & Make a Wish Foundation

Make checks payable to: The Morning Optimist Club

PUSHUP PARTICIPANT’S SPONSOR FORM:

NAME____________________________________________

PHONE # _________________________________CELL # ______________________

Sponsor’s Name Pledge Amount Cash or Check #

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TOTAL _______________

Sponsor want a receipt? Call John Morrow @ 309.764.1929

For More Information

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