Xelevate AMA Flying Flying Fest Fundraiser Registration

2024 FLYING FEST FUNDRAISER EVENT

REGISTRATION FORM Proceeds from the event will benefit the Epilepsy Foundation of VA and the Donovan & Bank Foundation
First Name:*
Last Name:*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Business Name: (if making a corporate donation)
Business Logo: (if making a corporate donation)

Cancelof
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Only:

I would like to setup an information table / display (table provided)I will bring my own table and tentI would like to setup an activity for the childrenOther
Are You Bringing An Aircraft To Fly?*

YesNoNo, I am not attending but would like to make a donation
RC Aircraft Type:*

Electric RC AirplaneElectric QuadcopterElectric RC Helicopter
Make:
Model:
Aircraft's FAA Registration Number:*
Academy Of Model Aeronautics Membership Number: *
Are you bringing additional Family Members?*

YesNo
List First and Last Names of your Family members. (You will need to pay the spectator fee for all additional family members.)
Xelevate Visitor Access and Acknowledgement

I acknowledge that Treetop Properties, LLC and Xelevate, LLC (collectively “Xelevate”) are permitting me to access and use the premises located at Taylorstown Road, Leesburg, Virginia 20176, on a non-exclusive basis, during the dates and times notified by Xelevate to me, for the purpose of visiting Xelevate’s facilities and engaging in any related activities expressly permitted by Xelevate. I further acknowledge that I have reviewed and agree to the Xelevate VISITOR ACCESS TO PREMISES AND FACILITIES TERMS AND CONDITIONS with respect to visiting, accessing, and using the premises and facility as a visitor, including but not limited to receiving a tour of the facility’s features. Such XELEVATE VISITOR ACCESS TO PREMISES AND FACILITIES TERMS AND CONDITIONS are hereby incorporated by reference into, and form an integral part of, this Xelevate Tour/Visitor Access Acknowledgement and Agreement. I HEREBY CONSENT TO ELECTRONIC TRANSACTIONS IN ACCORDANCE WITH SECTION 13 OF THE VISITOR ACCESS TO PREMISES AND FACILITIES TERMS AND CONDITIONS.
Signature - I agree to Xelevate's Terms and Conditions*

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My Products*
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Donations or Corporate Donations All donations are welcome including corporate donations. We will proudly display your logo to be featured at the event if you provide it. Type in dollar amount you want to donate in quantity box below:
$1.00 Quantity



Pilot DonationBring your RC Airplane, quadcopter etc. and fly with us!
$25.00 Quantity



Spectator DonationEnjoy the festivities, activities and watch the fun!
$10.00 Quantity



Total

$0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Card Expiration

Security Code

Please click one of the PayPal options to complete payment and submit the form.

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2024 FLYING FEST FUNDRAISER EVENT