4th Annual Camp Liberty Gala
Registration Form
Saturday February 18, 2017; 4:00 PM - 10:00 PM : Laurel Manor 39000 Schoolcraft Road, Livonia, MI 48150
Event Details: Howdy Partner, rustle up the gang and head over to the Western themed Gala to support Camp Liberty.
They’re serving up our best steer for the plated beef tenderloin and chicken with mushroom sauce feast. Our live
entertainment, open bars, games, and silent and live auctions are the best from across the Wild West.
Support our Troops: We encourage our guests come dressed as your favorite western character, but watch out, if you’re
not dressed for the occasion, the Sherriff may have to toss you in the slammer or fine you. Whether a Calvary scout, a salon
gal, a preacher, or just a cowhand or cowgirl, we encourage you to come dressed for the round-up. A Veteran couple (TBD)
will serve as the Gala Governor and Governess as our special guests. “Best Costume” Prizes for various categories.
Tickets: $85 per person; (Veterans/ Service Members receive a bonus $25 Gaming/Raffle Ticket Packet.)
Early Bird Drawings- Register early for 3 chances to win a $250 Special Gala Raffle Ticket packet. Packet includes 5 $20
“Crusader” Custom Motorcycle Raffle Tickets, plus $150 worth of Gala Raffle tickets. Drawings held 12/1/2015, 1/1/2016,
and 2/1/2016. Enter early and be eligible to be drawn in all 3 drawings; only 1 Early Bird win per person.
Costume Door Prizes:- Drawing for 2 door prizes, a $250 value each, awarded to a male and female; must be in costume.
Guest and Sponsor Registration: Available online at www.camp-liberty.org and click on the Diamond & Spurs Gala tab
4th Annual Camp Liberty Gala:
As a 100% volunteer based program, your participation is crucial to the success of Camp
Liberty. If you are interested in sponsoring the Camp Liberty Gala please review the SPONSORSHIP Form on line at www.campliberty.org. For those looking to attend, please register early so you can participate in the Early Bird drawings we are giving away.
Register On-Line, Request an Invoice, or Mail Payment to: Camp LibertyInc. Attn: Rick Briggs, 40550 Grand River, Novi, MI 48375
To request an Invoice please email Rick Briggs @ [email protected] or call (810)908-1901 for more information.
Camp Liberty, Inc. 501(c)3 EIN 46-0533307 : Available online: www.camp-liberty.org and click on Gala tab
Gala Registration Levels
Please
check the desired Level
Land Baron VIP Table Package - $1,500 each –(Save $500) Show your family or corporate colors off with a beautifully
decorated table & chairs. Choose your two colors from the Land Baron VIP Table color chart. Package includes: 10 $85 Gala
tickets, 10 custom glass mugs,2 bottles of Champaign/wine, $500 in VIP Raffle Ticket packets, and matching center piece.
Over $2000 value. Each Veteran also receives a bonus $25 ticket packet
.# VIP Tables ____ x $1500 = $_______
Standard Table Package - $950 each (Save $200) - Standard table with decorations. Package includes: 10 each $85 Gala
tickets, $250 in Raffle Ticket packets, and center piece. A $1,150+ Value. NOTE: Each Veteran and service member at table also
receive an additional $25 Raffle Ticket Packet.
# Standard Tables ____ x $1500 = $_______
Order Raffle Tickets today and save!
$25 Packet (SAVE $5): Get 5 $2 Red tickets, 2-$5 White ticket, and 1-$10 Blue Ticket
#____ x $25 = $______
$100 Packet (SAVE $25): Get $25 R,W,& B; 2 $25 Gold; 1 $20 ATF; 1 $10 Heads & Tails; and $20 50/50
#____ x $100= $________
$250 Packet (SAVE $125): Get 3 $100 Raffle Ticket Packets for an even better chance of winning! #____ x $250= $________
Sponsor a Veteran Guest: $85 Per Individual Veteran Guest Ticket(s) or $850 Per Veteran Table (10 Vet Tickets)
Invite a Vet or we will help provide Veterans and spouses to fill your purchased seats if desired. Veteran Table
Sponsors will receive: Name displayed on the table and during slide show; and listing in the Gala Program.
NOTE: All Veterans and service members receive a bonus $25 Raffle Ticket Packet
Number of Veteran Tickets
____ x $85 each = $_______
Number of Veteran Tables _____ x $850 each = $_______
Civilian Guest Gala Tickets: $85 Per Gala Ticket(s) Number of Civilian Tickets _____ x $85 Each =
$_______
Door Prize or Live or Silent Auction Item Sponsor: Camp Liberty needs live and silent auction items and door prizes
to make the Gala extra special. Items valued over $500 will receive their name and logo shown on the slide show
throughout the evening, and listed in the Gala Program. Items donated that are valued between $200 and $499, will
receive their name listed in the Gala Program. To donate an item, please e-mail Rick Briggs at [email protected].
Monetary donation towards purchasing Prizes or Auction Items: Our Gala committee will do the shopping for you
if you’d like to donate an item or you can just make a cash donation and leave the shopping to us.
We pick the item for you.
Item you’d like donated: _______________ Amount you are donating $
______
REGISTRATION PAYMENT
TOTAL OF ABOVE ITEMS: $__________
Payment Methods  Credit Card (Discover, MasterCard, Visa)  Check: Payable to Camp Liberty, Inc. please
Name:
Address, City, State, Zip:
Attendees (List All, 10/table; Are they a Vet Yes or No):
2.)
_____________Vet Y/N
3.)
5.) __________
Vet Y/N
6.)
8.)
_____
Vet Y/N
9.)
Contact Phone:
____Total Amount Charged: $__________________
1.) ______________________ Vet Y/N
_______Vet Y/N
4.)
___________ Vet Y/N
_______Vet Y/N
7.)
______ Vet Y/N
_______Vet Y/N
10.)
___________ Vet Y/N
Contact Email:
Credit Card
Credit Card Number
Exp. Date
CSV Code (back of card)
Card Billing Address if different, City, State, Zip ____________________________________________________
Register early to win one of three $250 Special Raffle Ticket Packets
(5 each $20 “Crusader” Custom Bike Raffle Tickets and $150 in Gala Raffle Tickets.)
PHOTO BY: MICHAEL FARABAUGH STUDIOS
*
STATE OF MICHIGAN RAFFLE LICENSE # R388832