Participant’s Name: Teacher’s Name:

Checks/Money Orders Total $ + Online Total $ = Grand Total $

Fundraise Online: Save time and raise more money by visiting trikeathon.stjude.org to set up your fundraising page, where your sponsors can show their support with online donations. You can request donations using customizable email templates and social networks like Facebook and Twitter.

Please detach and send the envelope back with all the donations.

How do you participate?

1 Sign UpFill out the Parent/Guardian permission slip attached to this envelope and return to your child’s school or preschool.

2 Get SponsorsVisit trikeathon.stjude.org to set up your family's personal fundraising page to accept online donations. Share your family's page through email and social media. (Facebook, Twitter, etc.)

3 Collect DonationsSend thank you emails to online sponsors. Collect any check/cash donations and record them by using this sponsor form. For security purposes, please convert all cash donations to checks/money orders. Return the form and all checks and money orders to your school.

4 Join The RidePlease remember to bring your child’s helmet and trike or riding toy to the St. Jude Trike-A-Thon event. Your child will practice the lessons they have learned. We hope to see you there!

Visit stjude.org/trike or call 1-800-626-BIKE (2453) for more information.

Please detach and return this permission slip to your child’s school tomorrow.

Parent/Guardian Permission Slip¨ Yes, I want my child to participate in the St. Jude

Trike-A-Thon for St. Jude Children’s Research Hospital.®

My Child’s Name:

My Child’s Teacher’s Name:

My Name: (Please Print)

Parent/Guardian Signature Date

TRIKEST.JUDE

A-THON

CONSENT AND RELEASE FOR ST. JUDE

In signing this release, I (the “Parent”) as parent or legal guardian of a minor under the age of eighteen years, the “Participant”, permit Participant to attend and/or participate in the St. Jude Trike-A-Thon (“Event”) for the purpose of fundraising and/or raising awareness of and for St. Jude Children’s Research Hospital®

(“St. Jude”). I acknowledge and warrant that Participant is physically fit and able to safely participate in the event without risk to themselves or others. I, on behalf of Participant, understand that there may be risks associated in taking part in a physical activity and/or an activity and assume all risk of injury that may occur as a result of Participant taking part in the Event. I, on behalf of my child, the Participant, for myself, my heirs, executors and administrators, hereby agree to indemnify and hold harmless St. Jude Children's Research Hospital , American Lebanese Syrian Associated Charities (ALSAC) all public or private agencies whose property and/or personnel are used, all other sponsoring or co-sponsoring companies or individuals and all individual organizers or volunteers related to or involved in the Event (collectively Releases) from all liability to Parent, Participant and his/her personal representatives, assigns, heirs and executors, for all loss(es) or damages(s) and any and all claims or demands therefore, on account of injury to Participant or property. Parent hereby assumes the risks of loss(es), damages(s), or injury(ies) that may be sustained by Participant while participating in the aforementioned activity.

Important: Participants under age 18 cannot sign this form. Only their Parent or Guardian may sign on their behalf.

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What is the St. Jude Trike-A-Thon?The St. Jude Trike-A-Thon is a week long fundraising program that teaches kids riding-toy safety. As they learn the rules of the road, students gather donations to support the kids of St. Jude Children’s Research Hospital®.

St. Jude patient Benton, age 4, acute lymphoblastic leukemia

Who am I helping?Last spring, Benton’s parents noticed bruises on his arms and legs, but they chalked it up to time on the playground. But when Benton started to complain about pain, they became worried. A trip to the doctor revealed devastating news: Benton suffered from acute lymphoblastic leukemia. His family turned to St. Jude Children’s Research Hospital®, where he is undergoing two-and-a-half years of chemotherapy. St. Jude freely shares the discoveries it makes, and every child saved at St. Jude means doctors and scientists worldwide can use that knowledge to save thousands more children. “Benton hasn’t slowed down at all during treatment,” said Benton’s mom. “He still wants to do all the things he loves.” Benton loves Paw Patrol and playing outside.

Please sponsor me!Your donation helps ensure that... Families never receive a bill from St. Jude Children’s Research Hospital for treatment, travel, housing or food – because all a family should worry about is helping their child live.

• St. Jude is leading the way the world understands,treats and defeats childhood cancer and otherlife-threatening diseases.

• Treatments invented at St. Jude have helped pushthe overall childhood cancer survival rate from 20percent to more than 80 percent since we openedmore than 50 years ago. We won’t stop until no childdies from cancer.

My Goal for St. Jude $

Visit stjude.org/trike or call 1-800-626-BIKE (2453)

for more information. TRIKEST.JUDE

A-THON©2016 ALSAC/St. Jude Children’s Research Hospital (24154) TRK004017

___________

Please sponsor me in the St. Jude Trike-A-Thon.The St. Jude Trike-A-Thon teaches me riding-toy safety and lets me raise money for St. Jude. At the end of the week, I will bring my trike or riding toy to school to practice everything I learned. Please sponsor me by donating $25, $50 or more. Your donation helps St. Jude keep its promise to patients – that no family will have to pay for treatment, travel, housing or food.

Sponsors: Please make your check payable to St. Jude Children’s Research Hospital.

Por favor, ayúdeme a alcanzar mi meta de recaudación en el Trike-A-Thon de St. Jude.El Trike-A-Thon de St. Jude me enseña las medidas de seguridad para montar bicicleta y me permite recaudar donativos para St. Jude. Al final de la semana, voy a traer mi triciclo o bicicleta a la escuela para practicar todo lo que aprendí. Por favor, ayúdeme a alcanzar mi meta donando $25, $50 o más. Su donativo ayuda a St. Jude a mantener la promesa a sus pacientes de que ninguna familia tendrá que pagar por su tratamiento, transporte, hospedaje o alimentación.

Patrocinadores:Por favor haga su cheque a nombre de St. Jude Children’s Research Hospital.

Make additional copies as needed.

Sponsor’s Name (please print)

Address (Street, City, State, ZIP) Email Phone CollectedDonation

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¨ Yes / ¨ No

CHECKS/MONEY ORDERS TOTAL COLLECTED FOR ST. JUDE $ALSAC is an Illinois nonprofit, tax-exempt organization whose purpose is to raise the funds needed to enable St. Jude Children’s Research Hospital to find cures for children with cancer and other life-threatening diseases through research and treatment. Children are admitted to St. Jude without regard to race or religion. No family ever receives a bill from St. Jude. American Lebanese Syrian Associated Charities, Inc. (ALSAC) is located at 501 St. Jude Place, Memphis, TN 38105. For questions, Donor Services can be reached at 1-800-822-6344. We honor our donors’ right to change their communication preferences at any time. If you would like to make any changes, please write to us, call us at 1-800-606-3079, or e-mail us at DonorChoice@stjude.org. To ensure the privacy of our friends and supporters, St. Jude does not disclose or provide any personally identifiable information to anyone not acting on our behalf. Also, we share this data with service providers that have agreed to adhere to our privacy policy. Since this mailing may reach both U.S. and Canadian residents, please review the following information for your residence: For U.S. Residents: 100% of your donation may be eligible for a tax deduction. Although our financial report is always sent free to anyone requesting a copy, certain states require us to advise you that a copy of our financial report is available from them. To obtain financial information, reports, and information about ALSAC's purpose, programs and activities contact Donor Services at 1-800-822-6344, visit www.stjude.org, or write to 501 St. Jude Place, Memphis, TN 38105, or for residents of the following states, as stated below. California: ALSAC’s audited financial statement is available upon request to ALSAC. Florida: A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE, 1-800-435-7352, OR AT WWW.800HELPFLA.COM. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. ALSAC’s REGISTRATION NUMBER IS CH-431. Georgia: Upon request, ALSAC will provide a full and fair description of this and its other programs, and a financial statement or summary. Maryland: A copy of the current financial statement for American Lebanese Syrian Associated Charities, Inc. is available by sending the request to 501 St. Jude Place, Memphis, TN 38105 or calling 800-822-6344. For the cost of copies and postage, documents and other information submitted under the Maryland Solicitations Act are available from the Maryland Secretary of State. Michigan: MICS No. 3799. Nevada: American Lebanese Syrian Associated Charities, Inc. (ALSAC) was formed in Illinois. New Jersey: INFORMATION FILED WITH THE ATTORNEY GENERAL CONCERNING THIS CHARITABLE SOLICITATION AND THE PERCENTAGE OF CONTRIBUTIONS RECEIVED BY THE AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC. DURING THE LAST REPORTING PERIOD THAT WERE DEDICATED TO THE CHARITABLE PURPOSE MAY BE OBTAINED FROM THE ATTORNEY GENERAL OF THE STATE OF NEW JERSEY BY CALLING (973) 504-6215 AND IS AVAILABLE ON THE INTERNET AT http://www.njconsumeraffairs.gov/ocp/charities.htm. REGISTRATION WITH THE ATTORNEY GENERAL DOES NOT IMPLY ENDORSEMENT. New York: A copy of ALSAC's last financial report filed with the Attorney General is available by sending the request to ALSAC at 501 St. Jude Place, Memphis, TN 38105 or the Attorney General Charities Bureau, Attn: FOIL Officer, Department of State, 120 Broadway, New York, NY 10271. North Carolina: Financial information about this organization and a copy of its license are available from the State Solicitation Licensing Branch at (888) 830-4989. The license is not an endorsement by the state. Pennsylvania: The official registration and financial information of American Lebanese Syrian Associated Charities, Inc. may be obtained from the Pennsylvania Department of State by calling toll-free within Pennsylvania, 800-732-0999. Registration does not imply endorsement. Virginia: Upon request, a financial statement is available from the Department of Agriculture and Consumer Services, 102 Governor Street, Richmond, VA 23219. Washington: Financial and other information is available from the Secretary of State at 1-800-332-4483 or http://www.sos.wa.gov. ALSAC’s registration required by the charitable solicitation act is on file with the Secretary’s office. West Virginia: West Virginia residents may obtain a summary of the registration and financial documents from the Secretary of State, State Capitol, Charleston, WV 25305. Registration does not imply endorsement. REGISTRATION IN A STATE DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION OF ALSAC BY THE STATE. For Canadian Residents: The organization is not a Canadian registered charity at this time and donations do not qualify for Canadian tax recognition. The privacy policy for Canadian residents can be found at stjude.org/canada/privacy.