Gala Registration

Persons listed below assume full personal liability, and agree to indemnify and hold harmless all parties involved in the planning, organization and hosting of the gala event, including but not limited to the President of the Foundation, Foundation employees, board members, volunteers, agents, and anyone acting on behalf of the Foundation.

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Name of Company:
Address:
City:
State:
Zip:
Phone:
Fax:
Representative's Name:
Title:
Sponsorship Level:	-- Select --- Gold Sponsor VIP Sponsor Silver Sponsor Bronze Sponsor Corporate Tables of 10 Corporate Tables of 8
Description:

"Thank you to all our sponsors. We will be contacting you to make payment arrangements for your sponsorship."