Third-Party Event ApplicationThird-Party Event ApplicationInformation About YouName First Last TitleCompany NameCompany Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Event InformationWhy do you want to support Roice-Hurst Humane Society?How do you plan to promote your fundraising efforts?Will you need the use of the RHHS logo? Yes NoHow will you use the RHHS logo?What are the estimated proceeds to benefit Roice-Hurst Humane Society?Are there any other charities involved? Yes NoPlease explain any other charities' involvement in your proposal.Please describe any request for Roice-Hurst Humane Society staff support for consideration.Have you raised funds for Roice-Hurst Humane Society before? Yes NoPlease explain your past fundraising for RHHS.Date of event MM slash DD slash YYYY Beginning time Hours: Minutes AMPM AM/PMEnding time Hours: Minutes AMPM AM/PMHow often will this event occur?What are the anticipated expenses?Please note RHHS will not be responsible for any expenses accrued.Will you have event sponsors? Yes NoPlease explain.Will any alcoholic beverages be served? Yes NoPlease explain.Is insurance required for this event? Yes NoPlease explain, including whether you have already obtained insurance and through which company.Have you obtained the proper permits and license for your event? Yes Not yet, but plan to Not ApplicablePlease list any you have or are in the process of aquiring.Will this event have a planning committee? Yes NoPlease explain, including names, if available:Please note any additional information or requests.Please note that requests for animals will be considered on a case-by-case basis.Roice-Hurst Humane Society welcomes fundraising proposals for review, but choosing to submit a proposal does not obligate Roice-Hurst Humane Society to enter into a fundraising program with you. Additionally, you should agree to give all funds raised to Roice-Hurst Humane Society no later than 30 days after your program has ended. By submitting a fundraising application, you agree to assume all risks and liabilities associated with the proposal and hereby release and hold harmless Roice-Hurst Humane Society entities, their directors, officers, employees, agents and successors from and against any and all claims, damages, liabilities, costs, and expenses, including reasonable attorney’s fees arising out of or in connection with the event, including without limitation any personal injuries or damages to property that may occur in conjunction with your proposal. If Roice-Hurst Humane Society agrees to enter into a fundraising program with you, all written, electronic or printed fundraising program materials containing the Roice-Hurst Humane Society logos or trademarks, before and after your fundraising begins, must comply with Roice-Hurst Humane Society graphic standards and must be submitted to us for approval before circulation. By submitting a fundraising application you agree that you have reviewed The Roice-Hurst Humane Society Event Guidelines and The Roice-Hurst Humane Society Rules in Print. I agree. Yes, I want to stay connected with email newsletters and heartwarming stories from Roice-Hurst Humane Society.
