Feel the Burn Sponsor Form

Feel the Burn 5K Walk/Run

August 6th, 2022
Dear Potential Sponsor,

Derrick City Volunteer Fire Department will be hosting its annual “Feel the Burn” 5K Run/Walk on August 6th, 2022. The event will be held at the Derrick City Volunteer Fire Department at 451 Derrick Road with open registration starting at 8AM. All proceeds of the race will support Derrick City Volunteer Fire Department.

We are asking you to support this year’s event by monetary donation. Please fill out the form below. We ask that donations be made no later than July 22nd so that we can get our shirts made and make sure that you are recognized as a sponsor!

Any contribution made to the Derrick City Volunteer Fire Department is greatly appreciated. If you wish to be a 2021 sponsor please fill out the section below and return it with your donation. For your tax purposes, our Pennsylvania Tax I.D. number is 25-6056755. For more information about us or opportunities to support our non-profit (503-C) organization you can visit us at www.dcvfd.com.

Thank you in advance!
Event Sponsor's Name*
(Business, Organization or Individual)
Name of Contact Person*
Title*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number*

Area CodePhone Number
Authorizing person's signature*
Please type full name

Payment Option*

USDPlease enter sponsorship amount

Credit Card

Shirt Size:*
T-shirt comes free with sponsorship, thank you for your contribution!
Signature*

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Please Sign
If you are an event sponsor, please email your company logo to campbell.dcfd@gmail.com in jpeg or PDF format.

PLEASE SUBMIT ONLINE OR MAIL WITH PAYMENT TO: DERRICK CITY VOLUNTEER FIRE DEPT- P.O. BOX 58, DERRICK CITY, PA 16727
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