Contact Information
Name: *
Name:
Phone: *
Phone:
Address *
Address
Event Details
Will you be selling tickets? *
Are there any other beneficiaries of your event? *
If yes, please describe under "Event Description."
Will you have any of the following at your event? *
Select all that apply.
Will the event require any of the below? *
Select all that apply.
We will let people know about our event through: *
Select all that apply.
Please include venue, food/beverage, entertainment, marketing, permit/insurance fees, etc.
What will you be donating? *
Select all that apply.
Fundraiser Agreement *
I specifically agree to all the terms and conditions contained in the “Policies and Procedures for Community Events,” available at ChampionsLPCH.org/Policies. I understand that my event is not considered an approved event until written approval of my application is received from the Lucile Packard Foundation for Children’s Health (LPFCH). No amendment, modification, or waiver of any of the terms and conditions contained in this document and the “Policies and Procedures for Community Events” shall be valid unless in writing. At no time will LPFCH, or any representative of LPFCH, be responsible for the cost, planning, or staffing of my event, nor will they be liable for personal injuries or damages to property which may occur during my event. I agree to indemnify and hold harmless Lucile Packard Children’s Hospital Stanford, Stanford University, and the Lucile Packard Foundation for Children's Health and their employees, agents, and representatives, from any and every claim, demand, suit, and payment related to or caused by my event. I, the undersigned (or parent and/or legal guardian of the fundraiser if fundraiser is under 18) hereby agree to all the terms of the fundraiser agreement and the accompanying “Policies and Procedures for Community Events.”