Form – Register Passenger Big Bend Charity Rally

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Squadra Foundation

BIG BEND CHARITY RALLY

FEBRUARY 28TH – MARCH 1ST, 2020

PASSENGER REGISTRATION FORM

All passengers are required to complete the form below. By signing below and submitting this form, you agree and understand the terms and conditions of the “Liability Waiver Form“.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email * *

Phone

Driver Name * *

List name of the Driver for the car in which you will be a passenger.

T-Shirt *

Small
Medium
Large
X Large
XX Large
XXX Large

T-Shirt sizes are gender specific. If you select medium and you are a male passenger, you will receive medium men's shirt. If you select medium and you are a female passenger, you will receive medium women's shirt. Note, in order to receive your free t-shirt, driver must have paid the event fee, which covers one vehicle and two passengers. Additional passengers may purchase t-shirts at the event.

Lunch (Day Two Only) *

Yes, I want a packed lunch
No, I do not want a packed lunch

A packed lunch for our hike in Big Bend is included in the event fee paid by the driver. All other meals are at the participant's expense. Packed lunch includes a (1) wrap, your choice of fruit, (1) bag of chips, (1) cookie and (1) bottled water. If you do not want a packed lunch, you may eat at the Chisos Mountain Lodge restaurant at your own expense.

Select Wrap *

Turkey Wrap
Ham Wrap
Roast Beef Wrap
Vegetable Wrap
Vegetable Wrap
Vegetable Wrap

Select Fruit *

Apples
Oranges
No Fruit

Donation

All donations are optional and encouraged so that we can further support our cause.

Total

$0.00

Credit Card

Card Number

Security Code

Name on Card

Expiration/

Signature *

Checkboxes *

I have read and agree to the disclaimer below.

DISCLAIMER: By clicking submit: (i) I agree to the “Liability Waiver Form”; (ii) I consent to the Squadra Foundation collecting my details through this form; and (iii) I understand that if I am making a donation, I am making such donation to the Squadra Foundation while the Squadra Foundation is in the process of applying for 501(c)(3) status with the IRS. As such, any donations made prior to approval, will be retroactively tax deductible upon approval by the IRS; and (iv) I understand there are no refunds of any donations, if made.

Message

DOWNLOAD LIABILITY WAIVER FORM

Squadra Foundation Inc
108 Wild Basin Road South
Suite 250
Austin, TX 78746
Tel: +1 512 588 1750
Fax: +1 512 697 0046

STATE JURISDICTION: TEXAS
EIN: 84-3110477
STATE FILE NO.: 803423119
NTEE CODE: T30
CAUSE AREA (NAICS CODE): 813212
RULING YEAR (501(C)(3)): 2019

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