Raffle Prize Donation Form STOPS 5K Fun Run & Walk 2026
Donate a prize to support suicide prevention at our September 19, 2026 event. Please complete the form below to contribute. Contact Haley Ridgel at 985.264.8370 or haley@mywildmoss.com to drop off donation.
Donor First Name
*
Donor Last Name
*
Business or Organization Name (optional)
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Item Name or Description
*
Estimated Value (USD)
*
Any Restrictions or Conditions
Would you like to be recognized as a donor?
*
Yes
No
If yes, how should your name appear on signage and materials?
I agree to donate the item described above to the STOPS 5K Fun Run & Walk raffle.
*
I agree to donate the item described above to the STOPS 5K Fun Run & Walk raffle.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Questions? Contact haley@mywildmoss.com or visit stopsla.org
Submit Donation
Submit Donation
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