Stephen Dantzig Photography

Aloha! It is that special time in Hawaii where 20,000 poor rubber duckies get dumped into the Ala Wai Canal and make a mad dash to get OUT of the Ala Wai. These brave duckies give it up to support a great cause: The make their annual stinky swim so that children in Hawaii with Cerebral Palsy can get needed services. Services include Physical Therapy, Speech Therapy, Occupational Therapy as well as early educational interventions for kids before they enter the DOE at age 3. Here’s how it works: You adopt one or MANY of those ducks for a requested donation of $5.00 per duck (c’mon–me wearing a DUCK hat has to be worth $5.00!!). Besides, YOUR duckie adoptions help to keep those services afloat. Everyone wins (especially the keiki) but as a bonus, the fastest (and the absolute slowest) ducks win prizes for their adoptive parents! See the prizes below and then copy the entry form after the prizes and paste it into a word processing program. Print it, fill it in and mail to the address on the form! Many MAHALOS for your support! You can also GET ON THE BUS to support UCPA.

25^TH ANNUAL

GREAT HAWAIIAN RUBBER DUCKIE RACE

A Benefit for United Cerebral Palsy

Association of Hawaii

ADOPT YOUR DUCKIE  NOW!

Name:                                                                                                      

Last                                                   First                                  M.I.

Address:                                                                                                   City:                                            State:               Zip:                            Home Ph:                                       Cell:                                                 Email:                                                                                                       

Board member: Steve Dantzig

I wish to adopt:

       Single Duck ($5.00 - One (1) Adoption Certificate)

       Multiple Ducks (# of Ducks:    )

        Silver Duck Special ($15 - Two (2) Adoption Certificates and one (1) Silver Anniversary Duckie)

       Quack Pack ($25.00 - Three (3) Adoption Certificates

& One (1) Duckie T-Shirt) Circle shirt size:

Youth S   YM   YL   Adult S   AM   AL   AXL

           25th Anniversary Special ($100.00 - Twenty-five

(25) Adoption Certificates & One (1) Duckie T-Shirt) Circle shirt size:

Youth S   YM   YL   Adult S   AM   AL   AXL

·  Silver Anniversary Duckie pick up at the UCPA office or on race day only.

·  T-Shirt pick up at the UCPA office or on race day; or add $3.50 per shirt for postage &

handling (USA only).

 Check or money order payable to: UCPA of Hawaii

Or charge to my:              VISA                   Mastercard

#                                                                                            Exp.                    

Print Card Holder’s Name

Card Holder’s Signature

Total Charge Amount:                                 Mail form & payment to:

UCPA of Hawaii

414 Kuwili St., Suite 105

Honolulu, HI  96817

* $20.00 assessed for returned checks.

Adoption certificate(s) will be mailed to you. Mailback entry deadline is March 23, 2012. For more information call UCPA at 532-6744 or visit  www.ucpahi.org.

Visit your  friendly Hawaiian  Tel Federal  Credit Union  to  adopt  more ducks by March  16, 2012.