SMC Foundation Fundraiser Agreement Form
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By answering the following questions, you will help us learn more about your event.
A member of the SMC Foundation staff will contact you to discuss your fundraiser.
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| * Required information. |
| Name of Organization or Individual: * |
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| Contact Person (if different from above): |
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Address
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| Street: * |
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| City: * |
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| State: * |
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| Zip Code: * |
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| Contact Email Address: * |
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| Contact Phone Number: * |
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| Name and Description of Event: |
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| Event Date: |
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| Event Time: |
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| Event Location: |
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| Participation in this event is: * |
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Open to the Public
By Invitation Only
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Has this event taken place before?
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YES
NO
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If you chose "YES", when did it take place
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Are there other beneficiaries besides SMC Foundation?
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YES
NO
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If you chose "YES", please list them
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| Estimated Gross Revenue: |
| $
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| Estimated Total Cost: |
| $
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| Estimated amount to be given to the SMC Foundation: |
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$
%
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SMC Foundation works closely with many local corporations and businesses.
Please let us know in advance the names of any corporations
or businesses you plan to solicit for your event.
Please list below. |
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SMC Foundation will need to review all materials that include the names/logos
of Somerset Medical Center and Somerset Medical Center Foundation.
(Please read Logo Guidelines.) Please outline your publicity/promotion plans. |
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* I have reviewed, understand and accept the Event Guidelines, Logo Guidelines and Tips for Success.
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* I agree to fully assume all risks of injury or damage to me, my property or invitees to my property, as a result of my participation as a volunteer on behalf of SMC Foundation, Inc. I agree to release and hold SMC Foundation, Inc., Somerset Medical Center, Inc. and their respective affiliates, subsidiaries, officers, trustees, directors, employees, agents, successors and assigns from any and all claims, rights, demands, actions, causes of action, expenses and damages which I or my heirs, personal representatives, successors, assigns or anyone claiming by, through or under me ever had, now have, or may have against the parties identified above arising from my volunteer activities.
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Thank You and Good Luck!
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