The Ipswich Rotary 5k at Appleton Farms is sending all pledges to Rotary International's Polio Plus Program, a cause that has pledged to eliminate Polio and its devastating effects on children and families throughout the world.

Please use this form to help accumulate any pledge information or simply send a check to "Ipswich Rotary 5k Race Pledge."

Mail this completed form and the donations with your running entry form or bring to the registration area on Race Day.

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Street Address _________________________________

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For more info about Polio and Polio Plus visit Rotary International.