DELAWARE BREST CANCER COALITION
FUNDRAISING EVENT/ACTIVITY REGISTRATION FORM
Name of Event/Activity
Date, Time and Location of Activity
Type of Activity (golf tournament, 5K,
bake sale, salon fundraiser, etc.)
Organization or Sponsor
Contact Person Name
Address
Phone Number
E-Mail
Anticipated Proceeds
How will the Funds be Generated?
(Please state specifically how money will
be generated – 100% of proceeds, $5 for
each shirt sold, 20% of entry fees, etc.)
Additional Beneficiaries
Marketing/Publicity Plan
NOTE: The sponsoring organization should submit proceeds to DBCC within 60 days after the event.
Proceeds should be mailed to: Kelly Paustian – Delaware Breast Cancer Coalition – 111 W. 11th Street, Suite 3
Wilmington, DE 19801
HOLD HARMLESS ACT
The organization listed above agrees to indemnify and hold harmless the Delaware Breast Cancer Coalition, its
successors and assigns, against any and all demands, liabilities, costs and expenses whatsoever kind or nature,
arising from any claim by or on behalf of any person now or hereafter claiming any harm, injury or other claim
pursuant to that person’s participation in the fundraising event as set forth below.
Fundraising Partnership Guidelines
1. Please make every effort to have your event at a time that it does not directly compete with other
DBCC or non-profit fundraisers in the community.
2. Partnerships must comply with all federal, state and local laws governing charitable fundraising, gift
reporting, and special events.
3. Prospective partners should submit to DBCC a detailed proposal outlining the details of the
partnership.
4. Partnerships should be mutually beneficial with DBCC maintaining the right to negotiate the terms.
DBCC Partnership Paperwork Page 1
5. DBCC will evaluate the proposed partnership based on its mission and potential to enhance its
image. This may lead to a written report at the conclusion of the partnership.
6. All partnerships will require a letter/form of agreement between DBCC and the partner(s) that
delineates the details of the relationship, including but not limited to, roles, duties, timelines, use of
logo, involvement of DBCC personnel, approvals, etc. This agreement must be approved and
signed by both parties prior to proceeding with any aspects of the partnership.
7. DBCC will provide a camera-ready logo and approved copy for use in invitations, advertisements,
or other activities related to the event. DBCC’s name and logo must appear as approved by DBCC.
8. DBCC will review the progress/success of the partnership, both short- and long-term, and reserves
the right to decline participation as a beneficiary organization.
9. Under no circumstances may an individual keep any portion of the designated proceeds as profit or
compensation for involvement in the partnership.
10. All advertising and promotional materials for your event must clearly disclose to the public the
specific amount of money from the consumer’s purchase that will be donated to the Delaware
Breast Cancer Coalition (e.g., “$10 of each ticket purchased,” “10% of the sales price of this
product,” etc.)
11. Sponsors, underwriters, attendees and participants must make their payment for the event directly to
you, as the individual or organization conducting the event. You cannot offer sponsors,
underwriters, participants or attendees the option of writing their checks for the event
directly to the Delaware Breast Cancer Coalition for tax purposes, or otherwise allow them to
make their event payment directly to the Delaware Breast Cancer Coalition. You also may not
make any other statement or take any action which would imply that those payments are taxdeductible.
12. All partnership details posted on social media (flyers, save the dates, invitations, photos, etc.)
should tag the official social media pages of the Delaware Breast Cancer Coalition. Facebook
(facebook.com/DelawareBreastCancerCoalition) and twitter (twitter.com/DEBreastCancer).
I have read the guidelines regarding fundraising on behalf of the Delaware Breast Cancer Coalition and agree
to the terms and conditions therein:
Signature of Event Contact Person:
Signature of DBCC Representative
(note: event not approved until signed by both organizations)
A signed copy of this registration form (along with a certificate of insurance if appropriate) should be mailed,
emailed or faxed to:
Kelly Paustian ([email protected])
Delaware Breast Cancer Coalition
111 W. 11th Street, Suite 3, Wilmington, Delaware 19801
FAX (302) 778-1104
DBCC Partnership Paperwork Page 2