8085 Saltsburg Road, Suite 201
Pittsburgh, PA 15239
Benefits the United Mitochondrial Disease Foundation
www.energyforlifewalk.org/detroit
Dodge Park
Sterling Heights, MI
Visit www.energyforlifewalk.org/detroit for more
information.
September 17, 2016
The Energy for Life: Detroit Walkathon offers all
participants a fun-filled experience with entertainment,
refreshments, mitochondrial disease resources, and
much more! Start your team today!
1 Mile Walk
Please join the UMDF for the Energy for Life: Detroit
Walkathon as we unite in support of those individuals
and families affected by mitochondrial disease.
The Southeast Detroit Michigan Chapter of the United
Mitochondrial Disease Foundation is excited and
energized to be able to reach out to the community
to raise awareness as well as support those who are
fighting mitochondrial disease in our area. Whether you,
someone you love, or someone you know is fighting this
disease, we can all come together to spread the word
and raise money for research toward a cure.
W alk ...
About Energy
for
Life... About mitochondrial disease...
The money raised through Energy for Life Walkathons
supports the UMDF mission by:
•
Provide support to all individuals regardless of
diagnosis through informational packets, networking
and educational opportunities
•
Providing educational resources for families and
clinicians through UMDF Grand Rounds
•
Providing scholarships for families to attend the UMDF
Mitochondrial Medicine Symposium
•
Connecting world renowned experts in mitochondrial
medicine to affected families through various family
meetings and symposia
•
Mitochondrial diseases occur when the mitochondria in a
person’s cells cannot convert food into life-sustaining energy.
For many, it’s an inherited genetic condition. For others,
especially adults, the disease may be triggered by damaged
mitochondria.
Research tells us that one in every 200 people carries the
mutation that could develop into mitochondrial disease at
some point in their life. We also know that mitochondrial
dysfunction is at the core of many more common diseases
like Alzheimer’s, Parkinson’s, ALS, Autism Spectrum Disorders
and some cancers.
There is no cure for mitochondrial disease - yet.
A bout
the
the
Funding the best global biomedical research into the
causes of and effective treatments for mitochondrial
disorders
A bout
UMDF...
The United Mitochondrial Disease Foundation (UMDF)
provides support, education, and hope for better treatments
and ultimately a cure for Mitochondrial Disease.
The UMDF holds an annual symposium for professionals
and affected patients/families, coordinates support &
educational activities across the nation through volunteers,
and spreads awareness and education to the professional
medical community through our Grand Rounds program.
The UMDF connects affected individuals/families.
Since its inception in 1996, the UMDF has funded over $11
million in research, making it the leading non-governmental
contributor of grants focused on mitochondrial disease.
UMDF Mission: To promote research and education for the
diagnosis, treatment, and cure of mitochondrial disorders and
to provide support to affected individuals and families.
$
,
* I WALK IN
HONOR/MEMORY OF
* TEAM
NAME
* WALK
LOCATION
.
WORK PHONE
* HOME PHONE
PROFESSIONAL
DEGREE (MD, PhD)
* FIRST
NAME
EXPIRATION
EXTENSION
DATE OF
BIRTH
M
M
Online
Event
GENDER
$
$
D
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Office Use Only
,
,
D
Y
STATE
Y
* STATE
MIDDLE
INITIAL
F
.
.
Y
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* REQUIRED FIELDS
* PARTICIPANT / GUARDIAN SIGNATURE
Scan this QR pattern on your smartphone and register or
donate. Don’t have a QR reader app? You can download
one free from the App Store. Don’t have a smartphone?
Register online at: www.energyforlifewalk.org/detroit.
SIGN UP NOW ON YOUR PHONE!
DATE
For myself and my executors and administrators, I hereby release the UMDF, the City of Sterling Heights, Dodge Park, any event sponsors and any event volunteers and each of their respective
officers, employees, successors and assigns from any and all claims and damages arising out of any injury or condition that I may suffer as a result of participating in this event. Further, I
hereby grant full permission to any and all of the foregoing to use my photograph or any other record of the event for legitimate purposes.*
NAME
ON CARD
CREDIT CARD
NUMBER
I WANT TO MAKE A
DONATION OF
ZIP
CITY
COMPANY/ORG
ADDRESS
COMPANY/
ORG NAME
* ZIP
* CITY
* HOME
ADDRESS
* EMAIL
ADDRESS
* SUFFIX
(SR., JR., III)
* LAST
NAME
TITLE
(MR., MRS.)
TEAM
LEADER
PLEASE PRINT CLEARLY IN BLUE OR BLACK INK USING CAPITAL LETTERS. PLEASE KEEP ALL WRITING INSIDE THE BOXES.
R egistration F orm
Team Name: ___________________________________________
Walk registration is free! Preregister on our website or sign up the day
of the Walk. Collect money from your friends, family and co-workers
with the donations tracker to the right or ask them to make their
donation online!
You can still donate to the walk without selecting a specific team! Just
go to www.energyforlifewalk.org/detroit and click on ‘Donate to the
Walk’ under the Visitors section! Or use the attached form to send
your donation to the UMDF at UMDF, 8085 Saltsburg Road, Suite 201,
Pittsburgh, PA 15239.
Donate to the Walk!
Donate to a specific team by visiting our website – go online and visit
www.energyforlifewalk.org/detroit, search for the walk team or team
member and make your donation today!
Donate to a Team!
Step Three: Utilize the tools on the Walker HQ to promote your
walk team! Use the email center to email everyone you know,
share with your friends on Facebook, and encourage your
followers on Twitter to join your walk team or donate!
Step Two: Create your own fundraising website and personalize
it with pictures and stories. Set a fundraising and team member
goal for your team!
Step One: Sign up as a team with your friends, family,
organization, or register as an individual participant. Use your
creativity to come up with a fun team name!
Become a team captain and get your friends & family to walk with
you! It’s easy to start a team – visit www.energyforlifewalk.org/detroit
to begin.
Start a Team!
Walker’s Name: ________________________________________
Join the Walk!
$
$
4.
5.
$
10.
$
20.
Energy for Life Walkathon
- Detroit c/o UMDF
8085 Saltsburg Road, Suite 201
Pittsburgh, PA 15239
Detroit Contact Information:
Stephanie Tomlinson-Perron
stephanie.perron@umdf.org
Isabel Taylor, Co-Chair
isabeltaylor96@hotmail.com
Donation trackers can be mailed to the address below or presented on
race day. Checks should be made payable to “UMDF”. Please attach an
additional donation tracker if necessary, or have friends and family visit
www.energyforlifewalk.org/detroit for easy online pledge options.
TOTAL $
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$ 25
2.
1.
0. John Doe, 111 Redefine Hope Drive, Pittsburgh, PA 15239 , johndoe@email.com
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Amount Collected
In Honor/Memory of: ____________________________________
D onation T racker
Volunteer Registration: 8:00 am
Walker Registration: 9:00 am
1 Mile Walk Start: 10:00 am
Dodge Park
40620 Utica Road
Sterling Heights, MI 48313
G et I nvolved !
Sat, September 17, 2016
Energy For Life Walkathon