A-T Children's Project

Event Registration

Register your event: By completing and submitting this form, as the EVENT HOST for this event, I have read and agree to follow the A-T Children's Project's Fundraising Guidelines.

Auction items: The IRS requires us to inform the purchaser that the amount of the contribution that is deductible for federal income tax purposes is limited to the excess of money contributed by the donor over the value of goods or services provided by the organization.

Raffle tickets: Please check with your local government to see if you are required to purchase a raffle license. Raffle ticket purchases are not considered tax deductible by the IRS.

Event Registration

Please fill out as much information as you know now.

First Name		*
Last Name		*
Shipping Address		*
City		*
State/Province		*
Zip/Postal Code		*
Email Address		*
Day Phone		*
Home Phone		*
Organization Name if applicable

Name of Event		*
Type of Event (mini-marathon, dinner dance, walk, etc.)		*
Describe your event		*
Event Date (estimate if necessary)		*
Time of Event (estimate if necessary)		*
Location City		*
Location State		*
Location (physical place, name, address)		*
Target Audience (age, group, or geographical area)		*
How did you learn about the A-T Children's Project?		*



SPONSOR DRIVEN EVENTS (mini-marathon, walk, etc.) How much to raise to receive a t-shirt?
Projected Income from participants
Projected Income from Ad Sales (t-shirts, brochures, programs, signs, etc. Please list your items with prices:
Event Ticket price per person
Projected Income from Ticket Sales
Raffle Ticket prices (you may need a raffle license)
Projected Income from Raffle Sales
Projected Income from Live Auction
Projected Income from Silent Auction
Other Income Producing Activities (please list with price)
Projected Income from other activities
Corporate Menu (please list with pricing)
Projected Income from Corporate Menu
Any other projected income? Please describe:
TOTAL PROJECTED INCOME



Location/Equipment Rental
Per person RETAIL VALUE for food/beverage even it is all DONATED
Per person COST to participate (round of golf, bowling, etc.)
Entertainment
Insurance
Any additional expenses: please describe
TOTAL ESTIMATED EXPENSES

FUNDRAISING GOAL: Projected Income - Estimated Expenses = $

Comments/Questions/How can we help?

Fundraising will contact you soon.

The A-T Children's Project is a non-profit organization that raises funds to support and coordinate first-rate biomedical research projects, scientific conferences and a clinical center aimed at finding a cure or life-improving therapies for ataxia-telangiectasia, a lethal genetic disease that attacks children, causing progressive loss of muscle control, immune system problems, and a strikingly high rate of cancer, especially leukemia and lymphoma.

The A-T Children's Project is a registered charity in both the United States and Canada.

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A-T Children's Project, 5300 W. Hillsboro Blvd. #105, Coconut Creek, FL 33073 800.5.HELP.A-T 954.481.6611