R.A.T. Race Pledge Form

R.A.T. Race Pledge Form

Please fill out this form to pledge your support in the fight against human trafficking.
Participant Details
Participant's Name

First NameLast Name
Event City & Date (mm/dd/yyyy)
Participant's Event
Donor Information
Name

First Name/Business NameLast Name (leave blank if pledging as a business)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Pledge Details
I pledge a fixed amount of $ in support of the participant. I pledge a per-kilometer or per-hour donation of $ .
Pledge Terms

I will make a one-time donation of the fixed amount specified above.I will donate for each kilometer or hour completed by the participant.
If you would like to donate online, please use the PayPal address below to send your pledge. Simply copy and paste it in your browser's address bar. Please specify that the donation is for this event by adding and writing R.A.T. Race in the "Special Instructions" section of the PayPal donation form.

https://www.paypal.com/donate?token=sR0Ps5UZIXI5xFHritjg7Gu72umUsbGnBI9Veead4_AUdY6ZilVRJFuqOcQtI0lCZ6tELx3ZskUv2-f9
If you would like to donate by cash or check, please make checks payable to Change a Destiny. They will collect the donations and redistribute them to our various anti-trafficking partners. Please drop your donation off at the event or give it to the participant you are sponsoring to drop it off for you.
Receipt Request

Please send me a receipt for tax purposes.
Additional Comments
Date

MonthDayYear
Date
Signature

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R.A.T. Race Pledge Form

Participant Details

Donor Information

Pledge Details