EmailMe Form - Pledge Form for "Climb for the Soldier"

Image

Name *

First Last

Email - please note, all individuals pledging support will receive regular updates and pictures - if you would like to OPT OUT please check the box at the bottom of the form *

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Level of Pledge (Corporate Sponsors See Below)

$1.00 per 100 feet of ascent(max $30.00)

$30.00 Flat Pledge to Team

Other (please explain below)

Other

How I would like to fund my pledge

Please contact me after the climb

I want to make a flat donation now by credit card (see below)

I want to make a flat donation now by check (Please send to TVC AAAA, PO Box 102, Harvest, AL 35759

Please OPT me out of updates

name on the card

credit card number

expiration date

security code from back

zip code

CORPORATE SPONSORSHIPS

Does your company want to support the climb? Please complete the form below

Name

First Last

Company

email address

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Sponsorship Level

Flag Sponsor $100 - company logo is included on advertising material, and will be printed on a small flag - and printed on group logo flag displayed on summit and picture taken with team - (company recieves photo and small flag)

Flat team donation $30

Other (please note below)

Other amount

Method of Payment

Credit Card (see below)

check - please mail to TVC AAAA, Box 102, Harvest Alabama 35759

Total

name on the card

credit card number

expiration date

security code from back

zip code