Events

Third-Party Fundraiser Event Application Form

First Name

Last Name

Phone/Mobile

Organization Name

Event Information

Event Name

Start Date / Time

End Date / Time

Location

Description of Event

Type of Donation (select all that apply)

Monetary

In-Kind (Clothing Drive, etc.)

Other

Type of Donation (other)

Projected Attendance

Expected Amount of Donation

Are there other beneficiaries of this event?

Yes

Do you plan to solicit donations and/or sponsorships?

Yes

If yes, please list them here:

Does your event require the assistance of Crossroads volunteers?

Yes

If yes, how many?

What will be the role of these volunteers, and what times will they be needed?

Does your event require the presence of a Crossroads Staff Member/Representative?

Yes

Would you like the representative to speak at the event?

Yes

How much time is allocated for the speaker?

Publicity Information

All materials must be reviewed and approved by Crossroads Safehouse in advance of distribution.

Please describe your plan for marketing and promoting the event (press releases, social media marketing, flyers, etc.)

Is there an event website?

Yes

Web Address:

Please upload all advertising materials

Choose File(s)

Funds can be designated to Crossroads Safehouse, helping the organization meet its most pressing needs

Yes

If no, what alternative program would you like your funds to be designated to?

By pressing send, you specifically agree to all the terms and conditions contained in the “Policies and Procedures for Third-Party Fundraisers” attached to and made a part of this application. You understand that your event is not considered an approved event until written approval of this application is received from Crossroads Safehouse. No amendment, modification or waiver of any of the terms and conditions contained in this document and the “Policies and Procedures for Third-Party Fundraisers” shall be valid unless in writing.

At no time will the Crossroads Safehouse, or any representative of the Crossroads Safehouse, be responsible for the cost, planning, or staffing of your event, nor will they be liable for personal injuries or damages to property which may occur during your event. You agree to indemnify and hold harmless Crossroads Safehouse and their employees, agents and representatives, from any and every claim, demand, suit and payment related to or caused by my event.

If you have questions or experience problems with this form, please contact us by email or by phone at (970) 530-2353.

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