GALA Sponsorship Form

Healing with Horses Gala Sponsorship Form

Sponsor Name(Required)

Sponsor Name

Contact Name(Required)

First Last

Address(Required)

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

Phone(Required)

Email(Required)

Enter Email Confirm Email

Name you would like to appear on marketing materials.

Please provide the Sponsor name how you would like it to appear on marketing materials.

Website for marketing materials

Sponsorship Level(Required)

Derby Sponsor – $500

Exacta Sponsor – $1,000

Trifecta Sponsor – $3,000

Winner’s Circle Sponsor – $5,000

Triple Crown Sponsor – $10,000

Indicate the Sponsorship level you would like

Total

Credit Card(Required)

Cardholder Name

Card Details