3rd Annual Delta Down & Dirty The Largest Youth Mud/Obstacle Run in Mississippi
EVENT SPONSORSHIP FORM Sponsorships Appreciated in Full Before OR By October 2, 2015 Business/Organization Name Business/Organization Address Contact Person Name Contact Position/Title Business
Main Contact Ext.
Cell
Contact Phone Number(s) Email Will YOU Supply your OWN Banner? Do you WANT a CUSTOM Banner Created? Years Sponsored DDD? What are you wishing to sponsor? Please check all that apply.
YES
NO
(Custom 3ft x 8ft banners can be created and printed for $150) YES
NO
1 2 3 VOLUNTEER HOURS (Minimum of 4 hrs per person) MAJOR EVENT AREA ($500+) MAJOR OBSTACLE ($200) MINOR OBSTACLE ($100) Name
Cell
If Volunteering, please list names of all volunteers and cell numbers: If you are requesting a certain obstacle/area, please list here:
PAYMENT OPTIONS Completed Forms and Full Payments can be delivered to HPER Office in Forest E. Wyatt Center. Checks made out to: DSU Outdoor Recreation & Cash to be delivered to HPER Division Office with completed form. Requested check/cash pick-up can also be arranged. FOR ALL INQUIRIES, CONTACT TODD DAVIS – 662.402.2050 -OR-
[email protected] Credit Card Information with Registration Form dropped off to HPER Division on DSU Campus or Faxed to: 662.846.4571 OR scan and email form to
[email protected]. Mail form to: Delta Down & Dirty | HPER DIVISION BOX B2 | Delta State University | Cleveland, Mississippi 38733
Credit Card Number________________ - _________________ - __________________ - __________________ Expiration Date _________________ / ___________________
Security Code _____________
Name on Card: _______________________________________________________________________________
TOTAL SPONSORSHIP: $___________________ SIGNED: _____________________________________
