Miami » Fundraising Events Form

"*" indicates required fields

Benefiting What Organization?:*

Preferred event date:*

Please choose your preferred event date

Preferred Time:*

Please choose your preferred time

Backup date selection:*

Please provide a backup date

Backup Time:*

Please choose your backup time

Organization Information

Name*

Street Address*

City*

State*

ZIP Code*

Contact Name*

Contact Title*

Phone*

Email*

Mailing Address of Check (If other than above):

Name

Street Address

City

State

ZIP Code

IMPORTANT TAX INFORMATION NEEDED

Organization's Federal Tax I.D. #*

Please check one box below that applies to your organization:*

Recognized by government as a non-profit organization (or authorized sub-group). Please attach a copy of your tax exempt certificate or other official documentation recognizing non-profit status. your organization is a public school, government agency, church, or local chapter of a national non-profit group, no documentation is required.

Not recognized by government as a non-profit organization. Please note that you will be required to complete a Tax ID form (W-9) in order for your check to be processed. You will be asked to complete and sign this form by the General Manager at the time you pick up your master flyer.

PLEASE UPLOAD a copy of your tax exempt certificate or other official documentation recognizing non-profit status.

This information is mandatory.

Drop files here or

Max. file size: 50 MB.

Agreement Terms

Approval of this agreement is at the sole discretion of Dezerland. Please note that this agreement must be approved at least three (3) weeks before your scheduled Fun-Raiser event. This agreement may be terminated and/or cancelled on thirty (30) day's written notice at anytime during the term of the agreement by either party. The above organization will promote the Fun-Raiser event for the above Dezerland location only. The proceeds for the event will be a percentage of the pre-tax sales receipts for games or food or beverage. Participants must purchase a beverage with their meal in order to receive credit towards the Organization. One beverage per meal purchase. One flyer required per transaction. No other coupon or discount may be applied. By signing the contract, I understand that all flyers are to be distributed prior to the event, and under no circumstances are flyers to be handed out in the venue, mall, parking lot, or vicinity. The event traditionally takes place between the hours of 5 p.m. and 8 p.m. unless otherwise approved and noted on the contract by the General Manager of the above venue. A check will be mailed to the organization within 5-7 business days after the event. No guarantees, or warranties, of any kind are made by either party hereto as to the anticipated success of this event.

The terms above are agreed to and accepted by:

Organization Representative*

On This Date of*