RMHC South Florida | Third Party Fundraising Event

Name of Group/Organization:*
Address*
Street Address Address Line 2 City State / Province / Region
Contact Person*
First Last
Phone*
Fax
Email*
Promotion Name*
Date of Promotion
MM slash DD slash YYYY
From*

: Hours

Minutes

AM/PM
To*

: Hours

Minutes

AM/PM
Name of facility where event is being held:*
Address*
Street Address Address Line 2 City State / Province / Region
Description of Event*
Event Sponsor(s)*
Will you be serving alcohol? Are you selling alcohol?*
- Yes
- No
If yes, who has the liquor liability license?
How will the dollars be raised?*
How will the funds be collected?*
What percentage of funds raised will be donated to the charity?*
Please enter a number from 0 to 100.
Estimated expenses:
Estimated gross receipts: $
Does the applicant have a Certificate of Insurance to cover the promotion?
- Yes
- No
Carrier Policy #
Type of assistance requested from Ronald McDonald House:*
Will the RMHC logo be used on printed material?*
- Yes
- No
If yes, please attach a copy of material(s).
Max. file size: 1 GB.
Additional information
Who is providing food and/or drink?
Who is responsible for providing security?
Number of vendors/trade booths?
Description of goods sold or displayed?
Are you requesting an RMH representative at the event?*
- Yes
- No
Signature of applicant*
Date*
MM slash DD slash YYYY
No fundraising activity will be approved without receipt of a completed form. Thank you for supporting Ronald McDonald House Charities of South Florida.
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Additional information