How to Order

Please fill out and return this form and your payment to:Winston-Salem Dash

926 Brookstown AvenueWinston-Salem, NC 27101

(336) 714-2287 • wsdash.com

Donor name:

Address: City/State/ZIP:

Phone: E-mail:

Payment Type (circle one): *Credit Card Cash †Check

†Please make all checks payable to Winston-Salem Dash

More than 210,000 bricks were used in the construction of BB&T Ballpark.

The most important bricks, however, lie just outside the ballpark’s main gates.

Because when you reserve a commemorative brick for BB&T Ballpark, you’re not just investing in a keepsake that will be around for years to come; you’re also investing in our community.

The proceeds from every brick sold in 2012 will be used collectively by the Ronald McDonald House of Winston-Salem and the Winston-Salem Dash to further their Community Outreach efforts. This program will allow the Ronald McDonald House to provide a home away from home for families of children who are receiving medical care in our community’s hospitals.

The Commemorative Brick Program is one of multiple charitable programs spearheaded by the Winston-Salem Dash to benefit Winston-Salem and the surrounding communities.

Additionally, hundreds of thousands of fans each season will be able to see your brick and message, allowing you to put your own stamp on the Winston-Salem community.

Why a brick?

Number of bricks desired: One ($125) Two ($225) Three ($325) Four ($425)

R O N M C D

Honor your family and friends, memorialize a loved one, or celebrate a special event with an inscribed commemorative brick at BB&T Ballpark.

Each 4” x 8” brick may be purchased for $125. The brick can have a maximum of 3 lines and 18 characters per line, including punctuation and spaces. Additional keepsake bricks can be purchased for your home or office for an additional $100 per brick.

Please fill out the grid below as you would like it to appear on your brick, using capital letters only. Each line will automatically be centered on the brick. (The grey text on the bottom line is a suggested inscription in support of our 2012 charity partner, the Ronald McDonald House of Winston-Salem.)

Card Number: Expiration: CSV:

*For Payment By Credit Card

A L D H O U S E

Win

ston-Salem D

ash926 B

rook

stown A

venueW

inston-Salem

, NC

27101

The Ronald McDonald House of Winston-Salem provides a “home away from home” for families of children who are receiving medical care in our community’s hospitals. The House and Family Room programs offer physical comforts, emotional support, education, and referral services designed to promote the well-being of the whole family.

As one of five Ronald McDonald Houses in North Carolina and one of 315 worldwide, we are happy to open our doors to families of pediatric patients and invite them to stay with us. Our House offers 35 bedrooms for families, three living rooms, two playrooms, a playground and a kitchen with home-cooked meals almost every day.

In September 2010, the Ronald McDonald House of Winston-Salem doubled the size of the House and opened an additional 17,000 square feet to accommodate 18 more bedrooms! This means we will be able to serve over 1,000 families each year!

For more information on the Ronald McDonald House of Winston-Salem, please visit:

www.rmhws.org

About our partner

COMMEMORATIVEBRICK PRO GRAM