Jump Rope Athletics Sponsor Registration Form
Personal Information
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Sponsorship Details
Choose Sponsorship Level: (Please check one)
*
Gold Sponsor - $2,000
Silver Sponsor - $996
Bronze Sponsor - $120/month
Payment Information
Preferred Payment Method: (Please check one)
*
Credit Card (Link will be provided for online payment)
Automatic Withdrawals (Setup instructions will be provided)
Cash/Check (Details for mailing or drop-off will be provided)
Additional Information
Are you interested in receiving updates about the child you sponsor?
*
Yes
No
Would you like to receive invitations to competitions and events?
*
Yes
No
Additional Preferences and Information
Use of Funds Preference: (optional)
Tuition
Uniforms
Travel
Acknowledgment Preferences:
*
I agree to have my name/company acknowledged in public materials.
I prefer to remain anonymous in public materials.
Renewal Intent:
*
I am interested in renewing my sponsorship annually.
I would like to be contacted about renewal options.
Tax Receipt Needed:
*
Yes
No
Feedback Opportunity:
I would be interested in providing feedback about the sponsorship program
Agreement
I agree to commit to a one-year sponsorship and to the terms and conditions of the sponsorship. I confirm that all information provided is accurate.
*
Agree
Disagree
Authorized Signature:
*
Date Signed
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: